Nuggets for April 12

Here are a few items of note from the internet.

WSJ Health Blog
It's billed as the "WSJ's blog on health and the business of health". As a former subscriber (and business major in another life), I really enjoy the Journal's take on this subject. There are several posts on current healthcare business topics, so go on over and check it out.

Salt 'n Pepper Nursing (from EDNurseasaurus)
An interesting take on experienced nurses sharing information for the rest of us from someone who knows.

Before Code Blue: Who's minding the patient? (from Hell on White Clogs)
This post references a http://www.msnbc.com/ article of the same name (see the article for the link) addresses one of the most common causes of death in the hospital these days--failure to rescue.

I posted a reply to this conversation that followed because I felt a little uneasy about people dissing one year or accelerated program nurses and got an interesting reply.

Phones vs. Physicians-The Showdown (from fatdoctor)
Doc, it's not just you...those rascally patients drive us nurses nuts chatting all day on the phone, too. Somedays, you just wish they'd hang up!

Nuggets for April 8

Here are a few of my favorites from my recent ventures out on the 'net.

Nursing 101 (from ERNursey)
ERNursey, thank you for this post.

Don't buy liability insurance (from My 2 cents)
This is one of my favorite blogs, discussing a very important issue that, for some reason, people tend to gloss over.

Give it time (from tex at weirdnursingtales)
A good, short piece on ED nurses. I'm not there yet, either, Tex, but boy, my BS radar is gettin' pretty sharp!

Chez Recovery and Beyond (from pixelrn)
Boy, Beth, I sure feel for you...been to the IT promised land, escaped to nursing school, and now I'm wondering if I should ever go back. It's just TOO tempting!

Keeping priorities straight, even at the end (from nytimes.com)
The NY Times article about Carnegie-Mellon prof, Randy Pausch and his last lecture.

Nuggets for April 3

Here are a few goodies I've read lately from the internet and various blogs.

Doctor, did you wash your hands (from http://www.nytimes.com/)
This article discusses a study about patient questions to doctors and nurse. No, I don't mind if you ask at all.

60-plus, ripped and natural (from http://www.nytimes.com/)
This isn't your average bodybuilding article, and it brings up some really interesting points. Now, if they could just convince women to do it, not just for looks, but for the health aspects (like stronger bones, for one)

I don't like gas stations in the alternate universe very much (from drugnazi)
I really enjoyed this post, since I've had a few weird dreams like this myself.

I just couldn't pass this one up, in light of my recent dealings with car insurance companies.


see more crazy cat pics


Enjoy these goodies!

Nuggets for March 30

Patients driving you crazy? Some days, it seems like a really short trip. Here are a couple of goodies I've run into on the internet recently on this very subject and other interesting items. Enjoy them!

Driving your nurse crazy (from headnurse)
Things NOT to do when you go to the hospital. Sadly, I think I've encountered about 90% of these during my first year in nursing.

Failure to build rapport is not failure (from http://www.aboutanurse.com/)
May writes another one about dealing with a difficult patient.

The BON may just be the beginning (from Information for Nurses)
Taralynn Mackay provides some information on this very important item for nurses. And you thought your state BON was scary....read these!

A neighbor, a death and thoughts thereof (from digitaldoorway)
I really liked this first-person piece about a neighbor who suddenly passes away.

A few handy things for a new rehab nurse

Since I just realized that I'm closing in on one year as a nurse, I thought I'd share a few things for the students about to graduate who may be heading into rehab as their specialty. Your mileage may vary, but never fear...there's always room for innovation out there. Keep your eyes open!

1. Good shoes and socks.

You may have discovered this in nursing school, but if you have not, seek and find until you discover your favorite pair, and once you do, buy two pairs. Your back and your legs and the rest of your body will thank you.

I am also a disciple of Compression Socks. Some of you may think they're crazy, but I love them, since my feet feel great when I'm done with my shift. Besides, it's another way to educate your patients on wearing their TED hose. My favorite quote, "See, Bob (insert your patient name here), I've got mine on. Let's get yours ready to go."

2. Be prepared.

Just like they say in the Boy Scouts and Girl Scouts, it's good to be prepared. Especially when you have the patient in isolation who wants to be suctioned multiple times on your shift. I always try to keep a mental list of what my patients have in the room, so I can keep it stocked. It can get crazy, but you can do it. If your patients go to therapy, restock them while they're gone. If not, try to restock whenever you can. That extra minute of stocking can save you five when you're in a hurry.

3. Pillow cases work wonders in many situations.

This is a corollary of #2. I have used pillow cases as bibs, quick towels and as the occasional non-plastic Depend backup for a quad who had dig stim every morning but wanted a little more security when he went to therapy. They are also wonderful for use on the sliding boards (keeps the butt sliding to the commode, if you get my drift.)

4. Look, listen and learn from your peers.

Sure, you just got out of school (nursing program name here) and know lots of facts and figures, but on the floor is where the rubber hits the road. Hang back and watch first, then do. Pay attention and you will see who is doing things the RIGHT way (i.e. correctly following policy and procedure), and who is not. The older nurses on the floor may not do everything the way you think (or policy says) they should, but you can learn something from everyone. I would have never learned a better way to put a Foley in females had I not watched K. the pseudocharge at Saintarama. She was 99% on the first try with her Foleys on the floor and after watching a few times I noted some of her techniques--less lube and shorter grip.

5. The patient is the star of the show.

Yes, you'll have lots of competition in this category, especially doctors and other people demanding your time, but keep in mind that the patients on your assignment are your top priority.

When you get your assignment, they are yours until you hand them off at the end of the shift. Take care of them and give them your undivided attention while you are with them. Let them know if deviations may cause you to leave the room while you are working with them if this is feasible. Make each one feel like a million bucks whenever you can...even if you don't want to or feel horrible. That person in the room is someone's special someone, so make them feel that way when you are around, too.

6. Stay positive.

Yes, you may get into work and the sky may seem to be falling. Keep reminding yourself that you will have a good day, and you will get through whatever trouble may be cropping up here and there. You survived nursing school and have the license and skills to prove it. Use them, especially those coping skills. Just as animals sense fear, patients can pick up on crabby nurses pretty darned quickly. You'll make your patients feel better (and yourself) if you can model calm and collected behavior on the outside, even if you don't really feel too calm and collected inside!

Nuggets for March 26

Here are the latest articles of note I've read recently.

Night shift, sleep deprivation may be hazardous to health (from the LA Times)
More and more articles are discussing research into this very important issue.

High blood pressure runs in families (from Yahoo!News)
Another interesting study about hypertension.

Hospitals go automated (from kansas.com)
One hospital group's take on automation

Nuggets for March 20

Here are a few items of note for today:

Heparin Discovery May Point to Chinese Counterfeiting (from http://www.nytimes.com/)
I suspect I may get a few refusals to take this if people have been watching TV.

For amputees, an unlikely painkiller: Mirrors
An interesting therapy being studied to relieve phantom pain.

We take care of our own
Another installment on gratitude (and what happens when patients leave) from Podunk Memorial. Short...but sweet.

A nugget of a poem

Warning: if you have a weak stomach or are in the middle of your lunch break, come back later. Otherwise, continue, as you have been warned...

The Underside of Nursing always has an interesting ditty or two, but since some of the nursing bloggers I've been reading have been talking about bowels in one form or another lately, here's an ode to that potassium-ridding drug, Kayexalate.

Reminds me of Mr. G. Wonder how long he spent on the throne after leaving Saintarama with a going on 7 K a little over a month ago.

I'm always going to be wondering about the end of some of the stories I end up being part of as a nurse.

More later. Happy weekend all!

Nuggets for March 5

Here a few goodies I've encountered lately that I just have to share, because I'm that kind of gal.

If you think your day was bad category:

The Laws of Nature have been temporarily suspended... (from head-nurse.blogspot.com)
There's always something interesting going on with head-nurse, so check this out.

A minor tragedy in two acts (from gentlemansc.blogspot.com)
It's not nursing related, but some of you nursing students can appreciate this.
In the same vein, if you'd like to know what those instructors are really thinking, check out Rate Your Students, which is a snappier retort to http://www.rateyourprofessors.com/.

The trolls are on the loose at GuitarGirlRN when she discusses methadone users who try to score in the ED.

Finally, I found this article about seductive nurses from the Times online in the UK when I read this post at Nurse Ratcheds. They're both worth a read, but I really was ROFL when I saw this comment in the online story from the Times:

Oh good! I'm going in for a hip operation on my 86th birthday. I might get laid at last.
David, London, UK

A real code and nuggets for March 1

I went back to work yesterday, just to get into the computer and get access to my timecard. Saintarama, in their infinite wisdom, doesn't make this accessible to employees from home (since that would be too logical, maybe...) After fun and excitement talking to the Kronos admin, he let me in and I downloaded my report and left down the hall. One patient, Mr. R., was in the room on the left. I talked to my manager for a little bit and told her what I had done, since I had discussed it with her on Thursday.

J and K were working and so I talked to them on the way out. Things had just quieted down from the AM therapy rush. I wished them well for the rest of the day. I even chatted with S., the secretary.

All of a sudden, the code lights flashed. This has been a regular thing on our unit, since we were blessed with all sorts of mechanical difficulties. However, this was not a drill. Apparently, Mr. R. went down and Y. the tech called for backup. Uh-oh. J and K ran down the hall. S. answered the calls and told everyone who called the code was real. She got Mr. R's chart and I saw the contingent of docs, residents and the rest of the code team go down the hall. Dr. D. was going that way, so I gave him the chart, just outside the room. He passed it on, since this patient coding, was not his. Hubby and I walked off the unit with him and I told him that I was finished at Saintarama. He was surprised, but wished me well. It turns out, he lives two blocks away from Saintarama. He knows how I feel.

After that, I came home and just surfed away. Here are a few of the interesting things I encountered yesterday, and some today. Enjoy!

Not sick, but TIRED (from aboutanurse.com)
A post that makes me tired just reading it!

An old poster with a timeless theme (at weirdnursingtales)
Thankfully, we don't see much of this bug in rehab, at least not in the ones I've worked in lately.

The Great White Hunter and the ER Nurse (from Nurse Ratched's Place)
I just love this story of bait and switch and revenge. The security part is the best.

The problem with "you" nurses (from first do no harm)
A great story from Podunk Memorial. Oh, CYA, the story of my life...

Nuggets for February 29

Yes, it only rolls around every four years, so I figured I may as well go celebrate.
Here are a few nuggets from the blogosphere and internet for your viewing pleasure.


Fed up (from GuitarGirlRN) Things I've thought about techs on the floor for a while...and the irritations they cause.


Scot free (from 10 out of 10)A great post on police and drinking drivers.

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.

Nuggets for February 13

It's almost Valentine's Day and here are a few subjects I'd love to talk about...and subjects some bloggers have already discussed in some interesting posts.

To the doc that rounded on my patient yesterday...
code blog's great "letter to a doc" on infection control. If only they'd all read it! Just drives me nuts!

Sayonara
May's about a nurse post on finishing your shift with a dying patient. I think about this when I leave to be gone for a couple of days.

Intimacy
I found this post at dogfoodsugar. It speaks to a lot of things I've been wondering about, including Dr. B. and his crazy relative who I took care of for a month recently.

The latest nuggets

Here are a few goodies I've found on various blogs on the 'net. Enjoy!

Help Wanted: Nurse with a Broken Heart
Mother Jones always has a good read, so check this one out. I wish I had Haldol sprinkles sometimes!

Nursing Pet Peeves
Add your own at this blog on Medscape Nurses.

Reducing injuries from moving patients
An interesting little article on moving people and how you can tone your body to do it right.

Fake it 'til you make it
A great little article on assertiveness from Everyone Needs Therapy.

Ten terrible patients
I found this link courtesy of the Information for Nurses blog. It reminds me of far too many of my recent patients.

Wiihabilitation
Forbes Magazine takes on one of the hot topics of rehab lately, use of the Nintendo Wii.

Nuggets for February 3rd

Since I've had some free time in between loads of laundry, here are a few choice nuggets I've read lately. Enjoy!

If you are a nurse
You'll always find a gem at Podunk Memorial. Some are oldies, but still goodies.

Die-hard sports fans face heart risks
From the NY Times, this article discusses cardiac risks for getting too charged up about your favorite team....just in time for Super Bowl. At least, they didn't do an expose on the appetizers and beverages you may eat!

Six Killers
This is a section the NY Times did in 2007 on the top six causes of death in the US. While it's not a leading health publication, there are some really good articles on these health issues, particularly the link between diabetes and heart disease.

Heard on the unit...

Today's installment, actually from yesterday, is mostly patient quotes. I would have had them up sooner but I was just too tired.

One of my patients is a retired high school math teacher. Fr. V. is also hard of hearing, so this makes conversations really interesting.

Me: "Father, I heard you were a teacher, what did you teach?"
Fr. V. "Idiots."
Me: "Weren't you a math teacher, Father."
Fr. V.: "Yes, I was. I only taught the idiots. The smart ones learned all by themselves."

Even funnier thing...one of his likely students (Mr. G.--he left on Tuesday) was about two doors away. Now I'll never know if Mr. G. fell into the smart ones or the idiots on his initial high school math classes.

Fr. V. also had some spiritual distress, once I got him thinking about tests. Neuropsych had sent one of their students to do an assessment on him and he could not hear her well. As a result, I had to call the neuropsychologist on his behalf to see if they'd let him retake his exam. It should be interesting.

"That night nurse really doesn't like her job, does she?"

Mr. R. mentioned this to me as I was assessing him. He told me this nurse makes him feel very much like an inconvenience and that he's just trouble. Sure, Mr. R. gets up at 0500 to watch the news and drink his coffee, so it's not as convenient as staying in bed. Now, I make sure he has his coffee in his room whenever I get on the unit. If he doesn't, I make him some. He's fallen twice since he came to us, and he's staying until he can get his new cervical decompression next week, so we have to keep him out of trouble.

This is a sore subject for me. I hate dissing my coworkers, but some patients are very observant, and now I know why some of them actually ask their docs if I can be their nurse while they are on our unit. I never actually say anything about the coworkers, so I just let the patients vent and get their feedback. Most are very positive.

More later...gotta warm up the car and go to work. Mr. R. probably needs his coffee by now!

Nuggets for January 24

Here are a few interesting nuggets I've seen lately: in various publications:

From http://www.nytimes.com/

• FDA requiring suicide assessment for new drug studies
• High mercury levels in tuna sushi
• Can too much cola cause kidney problems? Read this article and find out.

The latest nuggets

Here a couple of goodies I've noticed out on the 'net lately.

In the beginning (from highlytrainedmonkey)
A pithy remake of the creation story.

Advice from CNN (from movinmeat)
Things not to do in your favorite hospital's ER.

Goodie to share...

Yes, I'm getting ready for work, but I just enjoyed this little story from highlytrainedmonkey too much not to share:

Alternative Job Hazards
May we all have a tech on our units like Mama J.

Nuggets for January 5, 2008

Does the FIM scoring instrument used by many rehab hospitals make you crazy? Check out these links for more information:

MedFriendly has this FAQ about FIM
FIM is the product of UDS, or Uniform Data System for Medical Rehabilitation

NursingSpectrum has a nice short description on what rehab nurses do for students.