Monthly Archives

April 2016

I only wanted to see you Laughing in the Purple Rain

By | Events, Pop Culture | 2 Comments

Dearly beloved, We are gathered here today to get through this thing called life….

Today I got a little sentimental about Prince.  Or whatever symbol he was for that crazy period of time. Prince was one of the huge artists from my childhood, and maybe yours as well? Or maybe you are a new grad and your MOM listened to Prince.  Either way.  Prince is awesome.  Was.  SADNESS! My sister had a poster of him tacked to the ceiling and now he is dead.  prince

And way too young, I would like to add.

This is going to be a pretty short blog.  I was singing Purple Rain this afternoon, like half the planet.  I got teary over the Google Doodle….and had to listen. Then I got to the part of the song that goes like this…

Honey, I know, I know
I know times are changing
It’s time we all reach out
For something new, that means you too

news-0416-prince-600x400Maybe it applies to all of us.  It’s not like I am taking a song from 1984 and making it some mystical thing…. I just thought that it was relevant to us.  Because it IS time that we all reach out for something new. Unity. The old, awful lines that divide this profession are so destructive.  And for that matter, the old arguments that divide this nation should be relegated to ancient history.  These fossils which prevent change in our profession need to die.  Let it start with you. End the racism, sexism, destructiveness, divisiveness, persecution, general ridiculousness and cruelty with you.  Do not perpetuate everything that is wrong just because it has always been done this way.

Let change start with you.  

 

I will leave you with a quote from my favorite Prince song. It seems extremely appropriate to nurses:

Why do we scream at each other? This is what it sounds like when doves cry.

 

Love,

Janie

 

 

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Harriet Tubman, and why we should be proud to have her on the $20 bill

By | Unity | 2 Comments

Harriet Tubman is to be honored with a spot on the $20 bill.  We should be honored and humbled that she will grace it;  I hope we have her approval, posthumously.

She was born to enslaved parents as Araminta (‘Minty’) Ross around 1822. The exact date is not known. She was later married to John Tubman, who was a free black man.  She changed her name to Harriet sometime around her marriage.  harriet-tubman

This courageous visionary was a cook and a nurse for the Union Army before becoming a spy, and an armed scout.  She guided a raid that freed seven hundred slaves. She was the first woman to lead an armed mission in the war.  She saved seventy families from slavery, and transported them first to the ‘north’ and then into Canada when the Fugitive Slave Act became law.  She was a suffragette later in life

Harriet Tubman accomplished all of that with a traumatic brain injury, long lasting injuries from repeated beatings, and the life she lived as chattel.  Property. She was regarded as no better than livestock. Her head injury occurred when she was in a shop, and an overseer demanded she help him restrain a slave who had left the fields without permission.  She refused.  The overseer threw a heavy weight at the man, and it struck the adolescent Harriet in the head, nearly killing her. She was unconscious for two days, at which point she was unceremoniously ordered to the fields for work, while bleeding and in great pain. She had seizures, headaches and hypersomnia for the rest of her life.  It is suspected that she suffered from temporal lobe epilepsy. 

She didn’t let that stop her.

When Harriet made her run for freedom, she was assisted by kind people, mostly Quakers.  She describes crossing the line into Pennsylvania for the first time:

When I found I had crossed that line, I looked at my hands to see if I was the same person. There was such a glory over everything; the sun came like gold through the trees, and over the fields, and I felt like I was in Heaven

harrietShe made that return journey many times to rescue other slaves. First her family, then friends and strangers. One of her last missions was to rescue her parents.  Harriet floated families up rivers on rafts, and used risky disguises and tricks to get them to safety. There is evidence that she and Frederick Douglass worked together to bring some slaves to freedom. It is suspected that she brought eleven escaped slaves to his home, here is the quote from Douglass:

Douglass wrote: “On one occasion I had eleven fugitives at the same time under my roof, and it was necessary for them to remain with me until I could collect sufficient money to get them on to Canada. It was the largest number I ever had at any one time, and I had some difficulty in providing so many with food and shelter…

I could tell you Harriet’s entire history, but I won’t.  It is available everywhere.  She was the embodiment of American courage and spirit, while she was fighting unjust laws in America. I am so grateful that she will be the first woman and first African-American to grace our currency (Other than coins).  And remember, she served as a nurse.  I am doubly proud of her.

 

Love,

 

Janie

 

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But are you satisfied with your care?

By | Nursing | One Comment

Having worked in ER and ICU for the majority of my nursing career, I am used to being around some pretty sick people. It’s my happy place. My security blanket, if you will.  When I mentioned taking a desk job not too long ago, my husband’s mouth dropped open in shock.  His statement? “Janie, you will DIE OF BOREDOM if you are not around someone who could drop dead any second” .

care2I hope I don’t give off that vibe. 🙂

Quite some time ago, in a hospital far, far away a nurse took care of a patient in septic shock.  The patient arrested in the department right in front of her, and she can recall the snapping of ribs on her first chest compression.  Naturally, she winced a little, however, it is one of those necessary evils when saving a life sometimes.  Studies show that up to 97% of patients sustain rib fractures with CPR. They rarely cause any internal damage, and are usually completely uncomplicated.

There was a complication this time.  

The complication was that the patient was absolutely livid that her ribs were broken during CPR.  She completely recovered, by the way.  It wasn’t even a terribly long hospital admission.  She did REALLY well.  However, according to Nurses in the unit she transferred to, she had frequent complaints about how ‘That person doing CPR’ manhandled her and broke her ribs. She complained about not being treated ‘gently’.  She actually wanted to “Write a letter about how that person needs better training”. Luckily, a couple of the nurses and docs made sure she understood she was lucky to be alive.

So…..

As we all know, slow, gentle chest compressions are useless. The nurse’s chest compressions (and those of her coworkers) were properly fast and effective.  The patient lived. So why was she fixated on her broken ribs?

Because it HURT..  She was scared about what happened and fixated on the broken ribs. I get it.

And she did eventually (a few days)  stop complaining, laugh at herself, and realize that she had not been gently handled because it was not possible.

My question is….. what do you think she said on her patient satisfaction survey?

I guess it doesn’t matter, because she lived, so the goal was achieved. But it could financially matter to the hospital.  Satisfied patients are not necessarily the ones who got the best care.  This patient had no idea that broken ribs were a normal side effect of CPR.  She had to be educated repeatedly about it.  And she also expected to have a hospital experience with absolutely no pain.  NONE.

I think we might need to get better about educating the public that medical procedures are rarely completely painless. care

 

Love,

 

Janie

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Your car is Nursing’s Billboard!

By | Unity | One Comment

Beginning this Saturday, April 23 and Safe Staffing Rally Day on May 12, we would LOVE to see pictures of your CAR!

car nichole

You can decorate however you like! Some suggestions are:

Safe Ratios Save Lives

Safe Staffing Event 5/12/2016 (with rally info for state or DC)

#NursesTakeDC

#SMYSOfficial

#SafeStaffing

#NurseWarrior

#NoLines

#WalkYourTalk

Please post your pic in our group or on our page so we can share your safe staffing spirit! I am told that these markers work great: Click Here Or you can buy them wherever! 🙂

Love,

 

Janie

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Nurse Burnout – Why you should worry about it.

By | Healthcare Policy, Nurse Politics, Nursing | 2 Comments

Everyone I know in nursing has said it.  We think it pretty often.  We feel like we are getting burned out, are already burned out, or in danger of being burned out.  While patients are in the hospital for a couple of days, we spend the better part of the year in there.  Every year.  Granted, we are (hopefully) not ill.  However, hospitals are stressful environments on the very best day.  They are even more stressful with chronic understaffing, insane patient satisfaction scoring systems that can cause our hospitals to lose reimbursement because a patient’s soda wasn’t cold, and nurses being expected to document everything 3-4 times.  Oh, and don’t clock out late, either please.  Finish that charting while you are taking care of 8 patients on telemetry.  Did you remember to post your strips?

Anyway…I digress.Stress-Test

When I was in the Navy, we had a saying.  A Dead Corpsman is no good to anyone.  This was naturally a reminder to keep yourself safe, because if you get shot, burned, stabbed, etc you cannot help the wounded.  In the Nursing world, we need to follow this sage advice, given to my by one Master Chief Conyers in 1991. If you are injured, mentally or physically; you are no good to your patients.  You can make deadly medication errors, and suffer compassion fatigue that completely destroys the quality of your care.  It can also decimate how you relate to your family and friends.  Burnout is no good.

And yet, it is an epidemic.

Recipe for a retention disaster:

Recently, we have been understaffed at my job. For the past year, actually.   I came home today feeling completely exhausted, and thinking about a change.  Considering the pains it takes to hire someone at my hospital; the extensive federal background check, and the 9 months it took to hire me, this is bad (and expensive) for the organization.  I work in Cardiac Electrophysiology.  It is easy to hire a procedural nurse; and hard to hire one who even minimally understands what is going on in my specialty.  I have also recently taken on additional responsibilities to cover another nurse who has been ill.  So, doing the job of two people, shorthanded for a year, and rarely taking breaks. This is not going to turn out well in most situations.

distraught-nurse-5361035Luckily, I work with a good manager and ‘sister’ department who assist us whenever they can, but this is only a band aid.  A small, not very sticky off-brand bandage, holding back a flood of hard feelings and desperation.  No amount of temporary help can fix a badly-staffed department; and it makes me hesitant to ask for time off because I know there is a small possibility it could impact patient care. Departments like mine need stability, and people who know what to do in the instance of a (very rare) serious complication.  It concerns me that we are short-staffed, and it makes me hyper-vigilant.   I worry about failing to notice signs of decompensation during a procedure, or breaking the sterile field, or stimulating the heart to pace inappropriately.  It hasn’t happened yet, but what if it does? It is exhausting, and makes it hard to ‘turn it off’ when I get home.

Unfortunately, What draws us to nursing is the thing that makes us so susceptible to burnout – we have a desire to care for others, even at the expense of our own well-being. This is why so many nurses are leaving their first nursing job within a year. High turnover rates have a huge negative impact on quality of care.  This is not good for anyone. It is always less expensive to keep nursing staff happy, with a sense of accomplishment about the care they give; but healthcare organizations do not seem to be able to do this very simple math. Retention is cheap, turnover is expensive, period.  And it is not only expensive in salary and training dollars.  It is expensive in medicare reimbursement penalties for procedural complications, bad outcomes, poor patient satisfaction, and lawsuits.

Nobody wins.

So what is the answer?

It seems like a majority of the problems we have in healthcare can be fixed by appropriately staffing all clinical areas.  We, as nurses keep saying this.  Our voices must be raised as a united profession to protect our patients.  I encourage you to share this post with everyone you know, including laypeople.  Make sure they know that we are worried about them, and that we are fighting for them.  It is time for the general public to fight WITH us. A short and simple list of things they should worry about:

  • Nurses who are exhausted from poor staffing and mandatory overtime make more errors; possibly fatal errors.
  • Nurses who work in a poorly staffed environment are more likely to leave the profession.
  • Departments with lower turnover give a better quality of care.
  • Nurses who are fresh and engaged will notice your deteriorating condition much faster than a burned-out nurse.
  • The hospital wants nurses to keep the staffing level a secret. That says it all.

 

Love,

 

Janie

 

 

 

 

 

 

 

 

 

 

 

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