Content That nurselyfe4115 Likes

nurselyfe4115, BSN, MSN, RN 4,509 Views

Joined: Apr 18, '12; Posts: 26 (15% Liked) ; Likes: 36
Registered Nurse; from US
Specialty: 5 year(s) of experience in Cardiothoracic Intensive Care

Sorted By Last Like Given (Max 500)
  • Oct 5 '16

    Correct... as an ACNP I perform the same (if not more) procedures as a PA. Keep in mind we are referring to an ACNP, not an FNP. An FNP does not get the same training.

    That would be one of the defining differences between a PA and an NP... NP's are (becoming) very specialized in their practice.

  • Sep 7 '16

    I follow some folks on social media who I keep on a “never miss their posts” list because they are well spoken and challenge me to be a better communicator. There are some posters here on AN who always add value, wisdom, and good thoughts to the discussion and I love to read their posts and learn from them.

    It’s also not unheard of to witness cat fights among nurses on social media, which makes a lot of us cringe. Plenty of people are watching to see how we nurses conduct ourselves. In social media, we really are on a stage with millions of viewers in the audience.

    Some of those viewers are impressionable students who are looking at us, the see if we truly are professional. To see if we walk the walk and talk the talk.

    Here’s some guidelines I follow for social media behavior.

    Use Other Words

    Moms tell their little ones “Use your words!” and it actually applies pretty well to us grown ups as well. It’s mental work to come up with and use more descriptive words. I challenge myself to collect more words, and build up my vocabulary.

    Instead of “that’s awesome” I try to say exactly how it was awesome. Maybe it was inspiring, or thought-provoking, or clever.

    Likewise, instead of “it was a crappy shift” or “my supervisor was awful” I’d say “my supervisor was insensitive (or arrogant, or demeaning)” and “the admissions were non-stop and I had 2 RRTs”.


    It generally takes longer to clearly articulate my thoughts and feelings than it does to be knee-jerk sarcastic or to indulge in a put-down.

    For example, instead of saying"you idiot" on social media, try to stop and think "What do I really mean? What am I feeling?"

    Maybe you think the person doesn't know what they're talking about, doesn’t represent the facts correctly, or is wrong. Instead you could ask,
    "Interesting, can you share your sources?" or “Can you help me understand your rationale?” or “That’s interesting, can you explain that a little more?”

    Use I Statements

    Avoid provoking others to anger or defensiveness. Try using “I” instead of “You” statements. Instead of saying “You aren’t making any sense” say “I’m having a hard time following you from point A to Point B.”

    Agree to Disagree

    If you don’t agree, say you disagree, but avoid name calling or put-downs.

    If you are feeling angry, just take a deep breath and wait before you hit “send”. Maybe even Walk Away from the Keyboard until you cool off. Nothing on social media is an emergency that demands an immediate response.

    Take the time to prepare and express your point of view in a well thought-out and respectful adult manner.

    Acknowledge Others' Feelings

    When someone else is venting you can acknowledge the frustrated or hurt part of them without dismissing them altogether or responding in kind. "That must be frustrating for you." They are probably communicating in the best way they know how, which, even if inappropriate, doesn't mean their feelings are not valid.

    It’s easy to depersonalize the person on the other end of text on your screen. But they are real, and they have family, friends, and feelings...just like you.

    You never how unkind and judgmental words will affect another person. They may be timid to venture onto social media again. Maybe the person is not a nurse, and now they think “Wow, that ‘eat your young’ thing must be true!”

    Respond to what they feel as best you can without, trying always to build each other up, and not to tear each other down.

    Beware the Temptations of Anonymity

    In social media, it's tempting to shoot from the hip, especially when writing behind an anonymous handle. Anonymity lets you sink quickly to your lowest self. It reminds me of my little brother, Robin. Whenever he got in trouble as a small boy, he would deny it and say "Bad Randy did it." He thought we wouldn’t find out- just like anonymous people think their online persona is not discoverable. It may be.

    Write as if you are not anonymous to hold yourself accountable, or write as if your mother or grandmother is going to read your words.

    Your thoughts? And I know you'll tell me nicely if you disagree lol


    Nurse Beth

  • Sep 2 '16

    DALLAS, TX September 1, 2016 – A cohort of international health organizations, resuscitation leaders, and emergency medical systems that includes the American Heart Association (AHA) – the world’s leading voluntary health organization devoted to fighting cardiovascular disease – today announced the establishment of the Global Resuscitation Alliance, declaring a bold goal of increasing cardiac arrest survival rates by 50 percent.

    To support these efforts in the United States, the AHA, the Seattle-based Resuscitation Academy Foundation (RAF) and Laerdal Medical announced the creation of the Resuscitation Academy Collaborative. The Collaborative will identify and disseminate best practices to combat and reverse the global public health crisis of poor outcomes from cardiac arrest.

    The AHA lends its recognized expertise as a world leader in resuscitation guidelines to both organizations. The U.S.-based Collaborative adds Laerdal’s strength in medical simulation and educational product design and, the RAF’s expertise in the practical implementation of programs within emergency medical services (EMS) systems.

    “Survival from cardiac arrest is tragically and unacceptably low,” said Mickey S. Eisenberg MD, PhD, Medical Quality Improvement, King County EMS, Seattle, WA and co-author of the paper that led to the formation of the Global Resuscitation Alliance.

    “One of the guiding principles of the Alliance is that communities can and must do better,” continued Eisenberg. “With adherence to and implementation of best practices, communities can increase survival from cardiac arrest by 50 percent.”

    Eisenberg’s own region of Seattle and surrounding King County reached an all-time high of 62 percent survival rates for bystander-witnessed cardiac arrest caused by ventricular fibrillation (VF). By comparison, the VF cardiac arrest survival rates in many other urban areas are in the single digits. Nationally, the survival rate for bystander-witnessed VF cardiac arrest is almost 40 percent.

    The two new groups emerged from the EMS2016 Congress in Copenhagen, Denmark and constitute years of international effort by health professionals to combat cardiac arrest globally.
    Cardiac arrest is a global public health problem, with an estimated one million fatalities annually in high-resource countries. In the United States, more than 350,000 people suffer out-of-hospital cardiac arrests annually, with just a 12 percent survival rate from all rhythms causing cardiac arrest.

    “It takes a tremendous amount of coordination to shape systems of emergency care that perform optimally,” said John J. Meiners, Chief of Mission Aligned Business at the AHA. “We’ve made good progress in the United States, and we hope to see continuous improvement in cardiac arrest survival rates as we share science and best practices around the world.”

    Cardiac arrest is a time-critical event that may be successfully countered with immediate cardiopulmonary resuscitation (CPR) and defibrillation with the use of an automated external defibrillator (AED) when indicated. Each minute a patient remains in cardiac arrest without CPR means their chance of survival drops up to 10 percent.

    The groups point to the wide disparities in how cardiac arrest is treated and the lack of trained bystanders in many communities as reasons that keep survival rates under 50 percent. They point to Seattle and King County as a leading example for how professional and layperson emergency response should operate.

    The Alliance aims to educate EMS leaders about best practices and provide tools to help improve survival in their communities. To complement this global goal, the Collaborative has established four initial recommendations for communities within the United States that serve as foundational steps for the integrated systems of care approach recommended by the AHA:

    · Dispatch first responders more rapidly. Process improvements may shave more than a minute in some emergency response dispatch centers.

    · Standardize the practice of dispatcher-assisted CPR. Ensure that 911 call centers know how to telephonically identify cardiac arrest and provide CPR instructions to callers. Both Hands-Only CPR and conventional CPR can double or triple a cardiac response victim’s chance of survival.

    · Continue to improve high-quality CPR. Healthcare providers should conduct regular practice as individuals and a team to ensure high-quality CPR as outlined in the 2015 AHA Guidelines Update for CPR and Emergency Cardiovascular Care (ECC).

    · Create a culture of leadership. Many of the improvements needed to strengthen the Chain of Survival require commitment from the community’s leadership. The Alliance seeks to inform and inspire relevant leaders on how to adopt a continuous improvement model of thinking.

    “Every community can improve its response to cardiac arrest,” said Ann M. Doll, Executive Director of the Resuscitation Academy Foundation. “If all communities follow the foundational steps, we can more effectively manage cardiac arrest outside of the hospital.”

    Utstein Implementation Meeting | EMS216 Copenhagen

  • Aug 22 '16

    Nothing Like a Nurse Navigator!

    “So it’s cancer,” my friend said, telling me the sad news about her recent breast biopsy. “They have been watching this nodule for a little while and it just exploded. The Nurse Navigator just called to set up my PET scan and some blood work before I go to the oncologist next week. She really encouraged me because she had such a ‘can do’ attitude and she helped me feel more in control.”

    We talked a while longer and then we hung up. As I put down my cell, I felt a mixture of shock, resolve and gratitude for this person, a Nurse Navigator, who could somehow help during this difficult time. Though my friend lives in another town, I began to want to learn more about our Nurse Navigator and just what the job entails.

    Nurse Navigators are becoming more plentiful as our health system shifts from one of inpatient, hospital-based care to a focus on preempting troubling symptoms and managing both complications and treatment on an outpatient basis.

    In order to find out more about the Nurse Navigator role, I talked with...Sherri Lawson, RN, BSN, OCN. She graduated from nursing school back in the 80’s and has had a career centered on oncology, starting out an an aide, then an LPN, and going on to serve as a floor nurse, a nurse manager, a resource nurse. While working as a resource nurse Sherri did community outreach, cancer prevention initiatives and cancer education. As the Nurse Navigator Coordinator, she currently is in charge of five other professional nurses who serve in this capacity in two different hospitals.

    What population do you serve?

    We work with all the patients who have a medical oncologist referral and we oversee the care of all oncology patients, watching for signs of complications. When a patient first receives their diagnosis, we are often right there, in the room. After the doctor leaves, we answer questions and schedule PET scans, Ports, Chemo Education, follow-up appointments.

    Nurse Navigators’ positions developed in response to a need. Patients were getting lost in the system and showing up for their first oncology appointments without the necessary tests, so time was wasted. We want to make sure that treatment begins as soon as is possible, given the patient’s condition. It is our role to keep track of people, to stay connected with them, to help coordinate their care and to take some of the burden of worry away. We also become a person that they can call if trouble arises.

    How long have Nurse Navigators been around?

    It is a fairly new field in our area, with the first positions starting in the 1990’s. I was the first one and had to work out my own job description. Now we have Nurse Navigators for lung cancer, breast cancer and for lung nodule follow up. There may be more positions opening as the focus on outpatient-centered care continues. We see it as our job to do excellent work in planning ahead, symptom management and appropriate referrals. At times we also serve as informal counselors when patients need to talk and get answers to questions that we are qualified to help with.

    What is your favorite part and your least favorite part of being a Nurse Navigator?

    Without a doubt, the patients are my favorite part. It is good to feel that they know they have a contact person for questions or concerns. It’s like throwing them a lifeline.

    The most challenging part is the sheer volume, trying to accomplish all that needs to be done. In an average day, we have contact with about 20 patients per day and make 30-40 phone calls. The Nurse Navigators generally attend the initial diagnosis-sharing physician visit and help answer immediate questions about what comes next. These appointments vary in duration but can take two hours or more. It is hard to do everything and maintain that high level of excellence that we know our patients deserve.

    If you wanted to be a Nurse Navigator, how would you prepare?

    In our area, the Nurse Navigators are RNs and have experience in oncology. They also tend to be independent workers, self-starters and people who are truly committed to quality care. Being able to work well with the medical staff, office staff and ancillary providers is also key. My long term experience in this hospital system is a definite asset and helps makes me more effective. But the most important part of being a great Nurse Navigator is doing it with heart and soul, having true compassion for the patients.

    Like most nursing jobs, the role of the Nurse Navigator varies from hospital to hospital and area to area. This is a snap shot of one Nurse Navigator’s job, her training and some of what she does day-to-day. You may have a much different experience based on your location and the system you work for. I hope you will feel free to share variations on the role in your responses.

  • Aug 20 '16

    What a great peek into the graduate student journey. I so agree that it's worth it. Once you have your degree, no one can take it away from you. What better to invest in than yourself and your own education.

  • Aug 20 '16

    I'm so excited for graduate school and to expand my learning. I love my role as an ICU nurse and I cannot wait to build on that knowledge base and be a provider.

  • Feb 4 '15

    In my hospital, you'd admit and discharge patients, do H&Ps, round daily on patients and come up with daily plan in consultation with the cardiologists, enter orders, examine patients and write daily progress notes, provide education, write discharge summaries etc. Outlook in my area (SW Pennsylvania) is excellent - they can't hire enough ACNPs. Salary depends on what you talk HR into really - there's a wide range. As a new NP, our range is around 32-50/hr (cost of living is low in this area). We work 4 x 10hr shifts per week mostly, some departments do 3 x 12s. You could also work in a CTICU, a lot of places now are staffing ICUs with ACNPs in conjunction with intensivists.

  • Feb 4 '15

    Job outlook should be good. In the NW, there's a limited number of cardiologists for so many patients. Mid level providers are needed to help manage chronic conditions like heart failure. I've worked with many many cardiologist as an RN, and they just want to mess with this kind of stuff. They usually defer to the NP or PA.