Kathleen Bartholomew

A Pause At The Door: Regaining Time with Patients

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Here is another excellent guest post by Kathleen Bartholomew, author of the book The Dauntless Nurse and website I am Dauntless.

I recently read that 70% of physicians said that their bond with their patients has eroded. I wonder what the statistic is for nurses? I’m guessing even lower as electronic charting takes up more than 30% of our time, and hospitals crunch staffing grids for survival.

Forming a bond takes time.

I remember an older man who seemed to be fighting death with all he had – even the doctor was perplexed! Finally I asked everyone to leave and listened carefully to his incoherent mumbling while giving him a bath. I discovered that when he was only 19 he had joined the Navy and gone to a brothel and was terrified of going to hell. I provided comfort and reassurance. There is no pill for a peaceful death. He died serenely within the hour.

Share your story! The stories of our bonds with our patients energize us and remind us why this profession is so amazing.

Maybe this lack of time explains why nurses have twice the depression rate – 18.2% compared to 9% for the general population. The time we have to listen and connect has eroded like a massive mudslide over the last 10 years as acuity and complexity increased and length of stay became shorter. As humans, we don’t notice minute changes because we are so awesome at adapting. How can we can reclaim this time with our patients again, and protect it from eroding even more? It was, and will always be, time with my patients that nourishes my soul and validates why I chose nursing in the first place.

What tips or tools have you found that are helpful to regain quality time with your patients? Try the ‘pause at the door’. Just stopping at the threshold before entering a patient’s room long enough to inhale and exhale deeply two times will have a centering effect on your nervous systems. When you have a list of 20 things to do, and medications are late, and someone turned up the invisible treadmill to high, use breathing as a powerful way to stop the crazy cycle. And any intervention that helps a nurse, helps the patient.

Try it!

Don’t miss Kathleen’s other guest posts

How Much Weed is Too Much Weed for Nurses

It all comes back to staffing

Late to the game:What can China and South Korea teach America?

A Loneliness Epidemic

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A Loneliness Epidemic

By | Blog, Kathleen Bartholomew, Public Health | No Comments

Kathleen Bartholomew is back with another excellent blog post. Kathleen is a well known Nurse speaker and the author of “The Dauntless Nurse”. She can be found at her website Kathleen Bartholomew as well I Am Dauntless.  You don’t want to miss her other posts on the SMYS Blog How Much Weed is Too Much Weed for NursesIt all comes back to staffing, and Late to the game:What can China and South Korea teach America?


Just this week a survey of 20,000 adults conducted for the health insurer Cigna found that 50% of adults said they sometimes or always felt alone or left out. That’s a big leap from 1985 when only 10% of our population had no one to confide in about serious matters.

Can you guess which age group was the worst affected? Ages 18-22. Alarming!

In our Instagram world where we are constantly texting friends and family, the Great Nothing of loneliness has taken up residence in our souls. What gives? It turns out that a “like” is not the same as real human connection where we feel truly seen.

Most nurses know that loneliness is a predictor of functional decline and mortality and is associated with depression, poverty, arthritis, and heart and lung disease. A 2010 study found that being lonely has the same effect on mortality as smoking 15 cigarettes a day!

Let’s recognize outliers and do something about strengthening community before Loneliness turns into yet another billing code and treatable commodity where big pharma can make big money by creating new drugs like “Forlorn-azol”, or immunize us from loneliness with “Dejectacillan”.

Look around. A good place to start is your own unit. Engage in conversation with someone new, initiate genuine conversation instead of always diverting into our own smartphones at breaks, and discover something unique and good to say about a co-worker every day.

We are over 3.6 million nurses. We can reverse this trend.

Tell us what you think in the comments section and over on the SMYS Facebook Page and join us in the SMYS Facebook Group

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Late to the game:What can China and South Korea teach America?

By | Blog, Healthcare Policy, Kathleen Bartholomew, Public Health | No Comments


This is the third in a series of guest posts by Kathleen Bartholemew, author of The Dauntless Nurse.  Don’t miss her first two blog posts, “It all comes back to staffing” and “How much weed is to much for Nurses“.  Check out all of Kathleen’s posts and leave comments below!

In 2008 both South Korea and China declared that gaming addiction was their number one public health problem. Today, these countries have sixteen treatment centers, a school internet screening tool, two week detox program and over 5000 counselors trained in internet addiction. In contrast, the CDC does not list internet addiction as even one of its top ten public health concerns – despite the fact that the screen time for America’s youth is over 7 hours a day, and that our children today only spend 4 to 7 minutes a day outdoors.

As a country we have failed to adequately acknowledge this crises as well as the impact it will ultimately have on our society. Most people do not even know that gaming in excess causes physical changes to the brain’s very structure at a time when it is still evolving. According to Dr. Hillarie Cash, founding member of ReStart Life, the signs and symptoms of addiction are:

  • Attention, learning and self-control problems
  • Impaired social skills
  • Emotional problems, anxiety, low self-esteem and depression
  • Aggression and indifference to human pain
  • Physical problems – eye strain, weakness, carpal tunnel
  • Strong correlation with sex and porn

Concerned, I paid a visit to the first digital addiction treatment center in the nation. Dr. Hillarie Cash  gave me a tour of the group treatment center at ReStART, but most enlightening were the personal conversations with the residents themselves who could barely make eye contact with me. Emphatically, these young men relayed what parents should NOT do:

  • Don’t tell kids its bad – tell them and show them the impact gaming has on their lives
  • Don’t get help until children admit there is a problem (it’s usually an event)
  • Don’t act like being on the internet is a reward
  • Don’t say “as long as you do what you are supposed to do (like good grades) then I don’t care

What should parents do? Unanimously these men wished that their parents had put parental controls on with explanations about the power of digital addiction – and they also wanted their parents to sit down and eat dinner with them. Real human connection appears to be a good antidote.

Pass this information along. Educate yourself on the powerful pull of digital media. Bring up the subject in PTA meetings, churches and social gatherings to help raise awareness in our society of the insidious damage of digital media addiction and inform your loved ones- in person! Or maybe download the APP “Moment” to monitor your own screen time (a reality check for my husband and I). As adults, set a good example. Over 60% of adults sleep with their cell phones at night, and half of adults read their emails during the night.

There has been a two year waiting list for ReStart Life for quite a while now – which clearly demonstrates the need. We may be late to the game, but there is still time for us to rally together to preserve the personal connections that make us human, and to protect our children from danger that they cannot see.

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It all comes back to staffing

By | Advocacy, Blog, Kathleen Bartholomew, Nurse Politics, professional, Workplace Safety | No Comments

This is the second guest blog post in a series of blog posts by Kathleen Bartholomew, author of The Dauntless Nurse. Make sure you check out her first blog post, “How much weed is too much weed for Nurses?“.

It’s been 14 years since the Institute of Medicine recommended that nurses not work more than 12 hours within 24 hours.

It’s been 8 years since the Joint Commission issued a sentinel event alert based on the evidence that connected extended work hours, fatigue and decreased patient and worker safety.

It’s been 4 years since Elizabeth Jasper was killed driving home after a 12 hour shift and Editor-in-Chief Maureen Shawn Kennedy wrote an editorial in the AJN pointing out that “Best practices” should also cover the health and safety of those who practice.”

What’s changed? If you listen to the voices of thousands of nurses on the front line, the answer is “Nothing – in fact, it’s gotten worse”. What is staffing like where you work? And how do you normally cope with short staffing situations?
Negative repercussions can be very subtle. One example would be the manager telling you that she can’t approve your time off (when she/he had previously agreed.) It’s difficult, but important, to still act professionally in all of these situations and to find common ground. One nurse approached her manager and began the conversation by saying, “I know you care about the patients and nurses here as much as I do….”

Do you ever feel retaliated against for standing up for safe staffing? Here is a list of some things you can do because so often we feel hopeless and underestimate our power:
• Make a report to the Joint Commission
• Never skip a meal or break – call your manager or house supervisor to step in for you and then keep going up the chain of command. File a missed break/meal report.
• Don’t feel responsible for your organizations failure to hire an adequate number of nurses – travelers, temporary nurses and a float pool are options they know they have
• Advocate for a resource pool to your Board of Directors by using specific examples from your daily practice of how unsafe staffing effected both nurse and patient safety
• Contribute money to your state’s Nursing Political Action Committee
• Stay connected to your 675,000 peers in Show Me Your Stethoscope!

But remember, the day that the profession of nursing is respected will be when nurses have the power to decide for themselves how many nurses they need. And that day is long overdue.

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How Much Weed is Too Much for Nurses?

By | Blog, Healthcare Policy, Kathleen Bartholomew, Medical Marijuana | No Comments

This is the first guest blog in a series by Kathleen Bartholomew, author of The Dauntless Nurse. Don’t forget to read her second post in the series “It all comes back to staffing

There -are now 28 states that have approved the use of medical marijuana – and 8 states recreationally. So chances are strong that some nurses are using marijuana for medical reasons, or for recreation. But how much is too much?

One joint in the 1970’s has the same potency of one puff today. Since 1998 the potency of marijuana has doubled. But what if you smoke a few hours before your shift? Edibles can take a few hours to feel the effects – and if you smoke it can take three hours or more to get out of your system. Having a medical-use card does not give nurses sufficient protection, as discussed this Medscape article.

Nurse Mary has lupus and a medical marijuana card. She also wants to make sure she is safe taking care of her patients; and that her license is safe. The laws don’t prohibit use unless it impairs practice, but employers can still take action. So both of these areas are still gray zones as marijuana is not supported federally, there is no consensus on toxicity level, and a hospital can decide independently to fire someone who tests positive whether they have a card or not. In Washington State for example, driving under the influence of marijuana is similar to driving drunk: 0.8 for alcohol – or 5ng/ml THC. But do you know your THC level when you arrive at work?

“If you consistently notice any of the problems listed below in a peer, it is your ethical obligation to compassionately go to your peer, and share your concerns. Our primary obligation as nurses is to protect our patients, but we should also care for each other. A large percentage of nurses are over the age of 45, so some of the symptoms below may be related to menopause! We shouldn’t jump to conclusions or make judgments, but most importantly we can’t ignore impaired nurses.

How would you handle a situation with a nurse that appeared to be impaired?

What would you do if a nurse had symptoms of being impaired by marijuana such as:

  • Short term memory problem
  • Impaired thinking and or delayed decision making
  • Decreased concentration
  • Impaired ability to perform complex tasks
  • Decreased alertness and reaction time
  • Paranoia and/or drowsiness (and of course, Increased appetite!)
  • Washington State Liquor and Cannabis Board

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