Content That sirI Likes

sirI, MSN, APRN, NP Admin 84,799 Views

Joined Jun 24, '05. Posts: 102,769 (17% Liked) Likes: 26,803

Sorted By Last Like Given (Max 500)
  • Feb 24

    "Too stupid to live" has been removed from allnurses.com facebook.

  • Feb 21

    Organizing your work day and family time can be difficult when you work odd hours and nontypical days. These tips, if utilized well will help you feel less stressed and more purposeful with your time each day.

    1. Make a Calendar

    Call me old school, but you need a calendar when you are a nurse who does not work a day time 9-5 job. The calendar can be a paper calendar or electronic. I like Google calendars because they sync to our phones for my husband and me to stay on the same page.

    2. Talk to Your Spouse

    Yes, you have to talk to your spouse. Making your life organized doesn’t help when you are the only one organized. You two have to be on the same page. As nurse, writer, mom, and assistant photographer, I feel for my husband. He has to pull up our calendar every single day to see where we're going day to day. My kids, 4 and 11, are involved in sports, and by the way, we try to have a healthy marriage by making time for us.

    3. Make lunches for the next day, the night before

    I have learned this time and time again because I get lazy at night, or maybe I’m just tired (see #2). In the morning, it gets crazy trying to get ready for work and school, let alone make lunch. We try to cut back on expenses where we can, and buying kids lunches is one of them. We don’t buy lunch at work, so they shouldn’t at school. We have food to make sandwiches, it goes on the list when we go grocery shopping every week. My advice, make those lunches the night before.

    4. Make a list the night before your day off

    I understand the pure exhaustion after working 12-14 hours a day. If you get a chance when you get home, or even throughout your work day, make a list for the day off. It only takes a few minutes. My list tops with “wake up,” my husband makes fun of me. As a nurse, you know life and death happens, if I don’t wake up, how could I start my list? See the humor? Ha. If you have a plan, your list will happen. My lists go something like:

    • Wake up
    • Make coffee
    • Write an article for:___
    • Throw laundry in
    • Pull out stuff for dinner (frozen chicken, etc)
    • Make boys lunches
    • Make a grocery list
    • Shower
    • Get kids to school
    • Do work (sometimes I break this down into what I try to get done in the 1.5 hours of preschool time I have)
    • Pick up youngest from preschool
    • Library
    • Grocery store
    • Let the dog out
    • Flip the laundry
    • Write some more after time with the little one
    • Make dinner
    • Go workout with kids/their sports

    The night time is the chill time, whether it's catch up on an article, or catch up on our shows, or life.

    5. Stay Active

    You have to stay active, no matter if you are skinny or fat. It is helpful to your health physically and mentally. Schedule it on your days off, and into your life. Looking back on that calendar, make yourself accountable to working out at least 2-3 days a week.

    6. Cook on your days off

    Many of us struggle with dinners for our families, especially if you work 12-hour shifts. I have a friend who let me in on the biggest secret years ago, the crockpot. Bust it out, my friends. There are healthy dinners for you to make while you are gone, and your significant other comes home. If you don’t have a crockpot, cook on your days off. Casseroles are great and can last a few days. Freezer cooking is also very popular!

    7. Meditate

    Have you ever used meditation? It’s not voodoo; it’s very helpful to help you destress and refocus. One of my goals is to meditate every morning. I have read a lot of articles about very successful people meditating to start their days, and how much it helps them.

    8. Destress

    Destress in the way that helps you destress. Many of us are so busy we have never found out WHAT it is that can helps us destress. For myself, until I was in my early 30s, I didn’t realize how much I appreciate nature! It is incredibly therapeutic to me! Spending time hiking, running on trails, or just walking with my husband and kids helps me so much!

    9. Add learning into your day

    Don’t be overwhelmed; this is a tip everyone should add into their organization of their day and to do list. “Learn something new every day” is a quote I live by. I truly do. You have to; there is so much to learn in this world. Whether it is at work, something new about your kids, dog, neighborhood, car, whatever it is, dedicate yourself to learning. If you are like me, add the quote at the end of when you realize you learn something new. For example, “The mother regulates the temperature with her baby with skin to skin contact---hmm learn something new every day.”

    10. ENJOY your flexibility

    With your busy schedule, and feeling like you lose a few days every week to your job, enjoy the fact that you work three days a week. Sometimes, you can enjoy a nap at 3 pm on a Tuesday, when everyone else is working. Enjoy mall walking with senior citizens, enjoy going to the grocery store when no one is there, volunteering in your child's classroom, and most of all, having time for you.

    Family time and work time is very overwhelming, but making time for yourself should always be required. To be the best nurse, best parent, and best person you can be, you need to focus on yourself and getting your days in order.

  • Feb 21

    Job stagnation is when you are no longer challenged at a job, but stay with the position because of the paycheck, the benefits, or possibly relationships with co-workers. How do you know that what you are facing is job stagnation? To be clear, almost everyone has a day or week at work when we just want to throw in the towel, either because work is insane (based upon population or demand) or our own life stresses are impacting our work life; for some reason, work just seems horrible. But, when this feeling is every day and lasts for a month or more, and you’ve even tried to take a vacation (which can sometimes recharge your batteries and give you a whole new outlook), maybe you realize you have hit a wall with your career, and you are just in the wrong job right now. Job stagnation is a bigger realization that you need a permanent change.

    Boredom

    You go into work and just do not feel excited for the day; the days meld together and feel monotonous. Why would you want to go in? Some people are really happy doing the same thing every single day, but if you don’t feel that way, then it may be time for a change of pace for you.

    Lack of Learning

    Not only do you feel bored, and a lack of challenge at work, but you don’t feel like you are offered any education to learn new skills...which you can eventually master. Your job should be offering to support you by sending you to courses off unit to learn more about your current patient population, and the current and most up to date standards of care. If there is a lack of funding for off unit education, education should be brought to you. You may be an expert in your patient care area, but there is always something new to learn, and you should be excited to learn!

    Overwhelmed at Work

    So the opposite of feeling bored, is that you are constantly feeling overwhelmed at work by your workload and completely under supported by your nursing leadership team. Just as much as no one should dread going to work because they are so bored, you shouldn’t feel like you are so overworked and under supported that you are anxious and stressed about going to work. Not only is that not good for your mental and physical health, but no job is worth that.

    Opportunities for Growth

    If you verbalize to your manager that you are interested in furthering your career, and they are unable to support you, either because there are no actual opportunities, or they choose to not support your opportunity for growth, your career is truly stagnant where you are. Whether you have a skill set that can be supported by a current open position in your unit/area or elsewhere in the hospital, and you have been overlooked, or there just aren’t any available, it may be time for you to move on to a different hospital or unit.

    Sometimes people are scared to make a huge change in their lives and to jump into a new career, perhaps a different nursing unit, or hospital, or a different career altogether, like moving from adult med surg to pediatric oncology, or making the decision to go back to school for a Bachelors, Masters, or Doctorate degree. I have heard people say that it is a luxury to move jobs, and I am not sure that it is a luxury. It is most definitely a HUGE decision that impacts your family, your life, and it can be stressful to change insurance, pay processes, etc (if you change physical places of work), but the benefits on your emotional and physical well being can be so immense.

    If you feel like you may be stagnant in your job, do yourself a favor and just look at other jobs in the field/area that you’ve thought about, and just see what is out there for you. If you really feel the pull for one of the positions, just apply! There is no harm in applying for a job, going for an interview, and seeing what the other job might be like. Maybe take a day to shadow in this new position; it may be right for you, or it may not be, but sometimes just challenging yourself and looking at a new position, may give you some new perspective. You may decide that you want to take the leap into this new job because you just loved the staff, and you had a great feeling about the institution and administration, or you might see some red flags, like a lack of ability to grow in the role or a lack of support for continued education (somethings that you may have found as a dead end in your previous job), and maybe realize that it isn’t the right job for you. And if it isn’t? Keep looking! Network with other nurses that may love their jobs and look into all options; start a thread on allnurses.com to get some opinions from other nurses on what they love about their jobs. And, most importantly, keep an open mind.


    Don’t give up hope that a better job is out there for you, that will make you feel fulfilled. You may find that your dream job, where you can look forward to more than a paycheck every week, is out there waiting for you!

  • Feb 21

    Becoming a Healthcare Writer
    My pursuit of a role beyond the bedside

    There’s something you should know about me. I bore quite easily. The thrill and freshness of change is something I constantly crave. So, it was no surprise that after a fulfilling decade of hands on nursing, I was ready for yet another transition in my career. Due to some life changes I needed to find something less physical - and fast. I love being a nurse but after multiple roles, bedside care began to feel stale. I sensed there was something more waiting for me. The trick was to still use my degree (I had worked so hard for!) and wealth of knowledge obtained over the years. I still wanted to connect with patients and fellow RNs, just in a different way.

    Where to start? Commence google search... “Non-clinical RN jobs”. This simple search led me to an entire world of nursing I hadn’t realize existed before. Health coach, midwife, concierge medicine, forensics, legal nurse consultant - all fascinating but not for me. Keep searching. Educator, navigator, management - none of these even sparked a whiff of interest. Scroll, scroll, scroll… nurse writer. Pause. Keep reading. Excitement. I was head over heels with the idea of becoming a writer and writing about what I had come to know best.

    My honeymoon phase had begun. I was in hot pursuit of information. How would I even begin to break into this field of nursing? I had always enjoyed writing but other than some songwriting and poetry as a hobby, I hadn’t written anything substantial since college. Had the dreaded APA style changed yet again? I was getting ahead of myself.

    This article by Elizabeth Hanes (fellow bedside RN turned writer) is single handedly what gave me the confidence and starting points to break into writing. The article was short and sweet, to the point and filled with jump off points. I kept researching - what opportunities were there for nurse writers? There’s plenty. Magazines, websites, and journals all looking for original content. Online companies and hospitals seeking nurses to help write policies and patient education. Ghostwriting for other healthcare writers and authors. Online and in print learning modules needed to be created - remember all those questions we mulled over in nursing school? Or those we still endure for our continuing education requirements? Nurse writers can help create them. You could even start your own blog - although this felt a bit overwhelming to me. I wanted to get my sea legs first. Get my name out there.

    I began by writing… about anything. Sounds simple - but I had to be sure I could actually do it. I created a folder on my laptop entitled “writing samples” and got to work. I looked for writing prompts through searching for online writing contests. I bought a book from Writer’s Digest that gave tons of information on all types of paid writing gigs. I tried it all - romance, short story, poetry. I created my first nursing article, “A Nurses Sacrifice”. I submitted it to a large website...crickets. I kept writing, and submitting and writing some more. Reading other articles kept my busy as well - trying to find what writing style I liked reading and writing best. Deep in my many online searches I came across the need for writers and submissions on allnurses.com. I submitted again. Waited for weeks - heard nothing. Maybe I wasn’t cut out for this. Maybe you needed connections to break into this arena? Oh no.... maybe... I was... a terrible writer. Spiraling in self doubt I decided the only thing left to do was keep writing and gathering information on how to get better.

    Shortly after, I received an email from allnurses.com expressing interest in my article and a chance at pursuing a contracted writing position with them. I was so excited on my phone interview I actually teared up when I realized it could be a reality. To be honest - it’s not a job that will pay the bills on it’s own just yet but I was just so happy to be given a chance. It has been an incredibly supportive environment for a new writer. Like any career, we all need to start somewhere and pay our dues.

    I currently write a few articles for allnurses.com every month. I’m always looking for other areas of healthcare writing to break into as well. I scan (my now regular) websites each week, looking for freelance work that interests me. Apply, write, enter a contest, write, read, submit a proposal, write some more. You can never have too much material in your bank. That’s my honest advice to anyone interested in healthcare writing - do your research and just keep writing. Reach out. Make connections. The rest will sort itself out. I’m still very new to this field and still have so much to learn - but I am totally hooked.

  • Feb 19

    The Act

    I was a new nurse, and before I had even gotten my feet underneath me, I lost my footing and fell hard.

    I made a medication error.

    I was fresh off orientation as a brand new nurse on an orthopedic unit in acute care. I rounded with Dr. G on two of his patients... 2 elderly ladies in a semi-private room... the same semi-private room.

    Suddenly, Dr. G got my full attention as he barked out an order in my direction “Change that D51/2 NS to D5W on Bed A.” (My apologies for referring to patients by their bed assignment, but that’s how it happened). At least that’s what I thought I heard Dr. G bark... I mean, say.

    I was eager to be competent and efficient. So before Dr. G had even returned to the nurses station, I had the D5W in hand, ran in, took down the bag that was hanging, labeled, spiked and hung the IV. On Bed A... just like he had ordered. An expedient medical intervention by a skilled medical professional, Yours Truly.

    I was proud of myself.

    I was so wrong.

    The Repercussions

    My Nurse Manager called me aside later that day.

    “I need to see you. In my office.... Now.”

    The tone in her voice and her words was enough to cause me great concern and anxiety. I had a sick feeling in the pit of my stomach. I followed her into her office unsure what was about to happen to me. She seated herself in her chair behind her desk, and motioned for me to sit across from her. I quickly noticed there was nothing on her gleaming wooden desktop... Except for a single piece of paper. I suddenly felt a sense of doom.

    Without further ado, she informed me that I had administered the IV fluid to the wrong patient, which constituted 2 med errors. Apparently Dr. G’s orders read “Change the IV fluid on (Bed B) to D5W.”

    Uh-oh... So both patients had the wrong IV fluid. I felt faint as the blood drained from my face.

    In addition, and most important, I had not identified the patient. She proceeded to inform me that I was on three days suspension without pay, and to clock out immediately. She pushed the disciplinary form across the desktop towards me for my signature.

    As busy and short-staffed as the unit was, my mistake was clearly exceedingly profound, as I was being sent home mid-shift and was Banished from Patient Care for three days. I wasn’t indispensable after all. Because I was Unsafe. I gathered my things and walked the Walk of Shame with my head down in front of my peers to the elevator. I drove home in the early afternoon on empty streets without traffic. Home to an empty house in the middle of my workday.

    How Could This Happen?

    We all know the 5 (6, 7, 8 and climbing) Rights of Medication Administration:

    • Right Patient
    • Right Drug
    • Right Dose
    • Right Route
    • Right Time

    So what had happened? How had I failed in something so fundamental? There are many things that contributed to my error. Here are three that I was responsible for:

    1. I opted for speed over process and safety.

    I took a shortcut by failing to check the written orders,note them, and identify the patient. Following the same process step by step without variance prevents errors. Like an airplane pilot. I learned an invaluable lesson well that day.

    BE THE PILOT.

    2. Ego. Pride.

    I was eager to please and perform. To show everyone, esp. Dr. G, what a bright new RN I was. Because surely Dr. G was going to be impressed by how fast I could make his orders happen. Looking back, I’m pretty sure he was only vaguely aware of my presence at all, and the only thing that might have caught his attention was if I had hung that IV wearing a tutu while whistling Dixie.

    3. Unintentional learning- maybe the most interesting.

    I had been an LVN before becoming an RN. At the facility where I worked, LVNs did not manage IV fluids. So oftentimes I would be in the room and watch the RNs hanging IV fluids.

    I admired their physical grace and coordination while nonchalantly flipping IV bags upside down, backfilling, spiking, reaching to hang….and I so wanted to be one of them! A bona fide RN with IV hanging privileges. But never in those scenarios I witnessed did the RNs ever check armbands for IVs. So the unconscious learning that took place…and that was indelibly imprinted…was that IV fluids are not medications! Crazy, huh? But that learning was exactly what happened…unintentionally.

    Of course, in nursing school, there must have been that day where they said “IVs are Medications” Did I miss that day? Was I only studying to the tests, and not the real world? I don’t recall. There’s school learning and then there’s real learning. How real learning takes place is another blog. As I’m an Educator and all.

    How I Felt

    Shock soon turned to utter devastation. I was on the crazy train. I felt shame, embarrassment. Confusion. I had always been the straight A student. Class President. Honor student. Failure and suspension were not me. I was one of the top RNs in my class. That person. Now who was I? It was ego shattering. My self-confidence vanished. Gone. Just like that.

    Once home, isolated and alone, my thoughts collided. Were the patients harmed? Would I be fired? Was I forever marked? How could I ever practice nursing again? My emotions reeled. I pictured another RN going in to my patients’ room and fixing my error. Hanging the right IVs.

    Making the mistake was one thing, but being suspended added gravity and shame. This was a felony, not a misdemeanor. I wasn’t angry about the harsh punishment. They must be right. I was sick and humiliated. Alone, I curled up and cried, but there was only an hour before my kids would be home from school, and I had to put on my Mom face. Dinner had to be made, homework had to be checked.

    Fortunately, the patients did not suffer any ill effects, but that was only luck, right? If I could do what I had done, I could make an even worse mistake, right? I could hurt someone. RNs aren’t supposed to hurt people.

    Added on was that I was a single Mom of three, and three days without pay was going to hurt. Although I’m sure that was the intent. The rationale being that if the punishment hurt enough, the lesson would be learned.

    And finally… I wondered if I should even be an RN. Hadn’t I just proved that I shouldn’t? Which was confusing, a cognitive dissonance. I had spent 6 years studying to be an RN with unswerving determination and… I shouldn’t be an RN?
    My world did not make sense.

    Recovery

    I didn’t need suspension. What I needed was counseling and support. Here’s what MeNow would say to MeThen:

    “Give yourself time, Beth. Time brings perspective, trust me. You don’t know this yet, but every, and I mean every, RN makes mistakes. Welcome to the real world. Reality check- you are not perfect. You also don’t know that you are going to be a gifted nurse. And go on to help a lot of people. Figure out what went wrong and learn from your mistake. Find someone safe to talk to. Forgive yourself.”
    And also from future Me: “Have a glass of wine. You don’t know this yet, but a robust Cabarnet is going to be your favorite.”

    I returned to work. From then on, I was obsessed with patient identification. Even if I was in the middle of a med pass, and turned around to grab a unit dose container of Milk of Magnesia out of the patient’s drawer, and walked back to the bed…I re-checked the pt’s ID. (This was before bar coding).

    Time passed, and my shaky self-esteem began to stabilize. Eventually the good days outweighed that one awful day, and my mistake was finally in the rear view mirror.

    Was that my last medication error? Well, as any nurse knows, that’s a rhetorical question. No, it wasn’t. Making mistakes never got easier, but recovery happened faster. My ego was shattered, but when it came back together, I was more resilient. Healthier.

    How did mistakes change you?

    How did you recover?

    I’d love to hear your feedback.

  • Feb 18

    When providing quality care for patients with eating disorders, the mnemonic WHATS UP DOC can help nurses at all levels of proficiency remember that there are multiple psychosocial factors and emotional subtleties involved. Whether your patient is suffering from anorexia, bulimia, binge eating, or any number of other recognized eating disorders or their precursors, this mnemonic can help you cover all your bases so you can provide your patient with the best possible care.

    This memory aid is promoted by the National Eating Disorders Association (see link in the “Sources and Resources” section below), and has been edited for allnurses.com readers in this article.

    W= Weight

    Weight is a “heavy” concept for patients with eating disorders. in other words, the idea of weight is loaded with meaning for the patient. The number that shows up on the scale is far more than a measurement to the patient, who is likely to attach a deep psychological meaning to the number, transforming it into a status symbol, a representation of self-worth, and/or a benchmark of self-control.

    H= Height

    While height is an important measurement necessary for calculating a patient’s ideal body weight, it is only one of many factors to be considered when assessing the progress of a patient with an eating disorder. Family history (yes, eating disorders run in families), individual nutrition and exercise patterns, weight history, and overall health status can be as important as height-weight ratios, and must be considered.

    A= Anorexia

    Anorexia is not the only eating disorder. While anorexia tends to receive the most attention from researchers and the media, other eating disorders such as bulimia and binge eating disorder are more prevalent in certain populations, are more difficult to diagnose, and may co-exist alongside anorexia. Providers and caregivers must consider all the possibilities and the big picture in order for the patient to receive proper care.

    T= Trauma, Trust, and Truth

    Trauma is often a precipitating factor for eating disorders; the disorder emerges as a coping mechanism for dealing with the pain caused by unprocessed or improperly processed emotions. Keeping that in mind, nurses must work hard to build trust with their patients so the truth can emerge in a safe environment.

    S= Sequelae

    The sequelae, or consequences, of eating disorders are both psychological and physiological and can be life threatening. Because the consequences of eating disorders intensify slowly over time, it can be difficult for patients to understand the long-term harm they are doing to themselves. The immediate effects of most eating disorders can be attributed to other causes. Patients need to be educated on both the short-term and long-term consequences of their behaviors.

    U= Universality

    Eating disorders are not limited to affecting young women. An eating disorder can strike virtually any age group: females of any age, males of any age, prepubescent children. Any socioeconomic, cultural, or ethnic group is fair game. The prevalence of eating disorders is growing worldwide due to the influences of the media and the Internet.

    P= Purging

    While it can be tempting to equate purging with vomiting, it is important to understand that purging is a concept that can encompass numerous practices the patient might use for maintaining or regulating weight. Examples include: diuretics, laxatives, supplements, enemas, over-the-counter diet pills, prescription medications, excessive exercise, over-indulgence in alcohol or other substances to the point of nausea, and other methods. Notice that there are substances as well as behaviors in this list. Be sure to ask what the patient does to maintain or lose weight.

    D= Dieting

    Excessive dieting is a precursor to most eating disorders. By honoring the topic of dieting as something that is very serious and worthy of in-depth exploration, you can provide your patients with the necessary education and support, including a true knowledge of the downsides and dangers of the long-term consequences of hypometablism and malnutrition. Providers and patients must take diet and nutrition seriously and approach the subject rationally.

    O= Office

    What messages is your office sending to patients regarding weight management? Everything from the magazines in the waiting room to the language providers and staff use regarding weight matters. Ask yourself sincerely, “Could our office be inadvertently contributing to the proliferation of eating disorders?”

    C= Consistent, compassionate, comprehensive, care

    This is what nurses do, anyway, but it is critical to recognize that great nursing care alone is not enough to treat an eating disorder. Your patients who are suffering from eating disorders need to be under the care of mental health specialists. Eating disorder sufferers must have compassionate care that is comprehensive and ongoing.

    Questions for comment
    :
    How will this mnemonic help you provide better care to patients with eating disorders?

    For more information on eating disorders, read my next article: Men With Eating Disorders are Underrecognized and Underserved

    Sources and resources:

    What's Up Doc? | National Eating Disorders Association

    NIMH >> Eating Disorders: About More Than Food

    Symptoms and causes - Eating disorders - Mayo Clinic

  • Feb 18

    Health news headlines in late 2016 drew attention to a Wisconsin man, Max Briles, 26, who passed away from complications related to anorexia nervosa. The Chippewa Herald reported that Briles declined treatment, at least in part, because he did not wish to be the only man in his treatment group.

    While eating disorders are still popularly thought of as diseases that primarily affect women, many researchers and medical professionals readily acknowledge that more men are suffering from eating disorders now than ever before. In fact, some sources claim that 40% or more of the individuals currently suffering from binge-eating disorder today are male.

    Sociocultural factors significantly influence the onset and treatment of eating disorders in both men and women. We live in a highly visual culture where appearances matter, where multiple generations have grown up with cyber-bullying, and without healthy, well-balanced, tangible, real-life role models. In this environment, disordered eating emerges as a response to the need for control. Eating disorders are often triggered by trauma, and then exacerbated by the mandates of weight-related athletics, perceptions shaped by media, perfectionism, self-esteem, and social anxiety.

    Nurses must be able to identify active and potential eating disorders and ensure the patient receives the correct treatment. To identify disordered eating in a male patient, it is important to recognize not only the precursors and triggers of disordered eating, but the ways in which men are most likely to respond.

    According to information in a recorded webinar * featuring Dr. Theodore Weltzin, a well-known expert who specializes in treating males with eating diorders, men express dissatisfaction regarding their life circumstances differently than women. “They go straight to a behavior,” Weltzin says. To help identify men with eating disorders, Weltzin recommends that providers and caregivers integrate targeted questions that specific to men’s experience into their history-taking process.

    Exploring the following topics with your male patients may help them open up in ways that provide opportunities for deeper probing and better care.

    → Have you been a victim of bullying, either in person or online?
    → How would you describe your desire for a more muscular body? (It may be helpful to phrase this question in terms of a 1-10 scale.)
    → To what extent do you feel your body’s appearance influences your ability to get a date?
    → Are you experiencing issues or concerns regarding your gender identity?
    → Do you have a history of sexual abuse?
    → How do you express your masculinity?
    → Are you satisfied with your body?
    → Are you experiencing decreased sexual desire?
    → Do you participate in weight-related sports?
    → Have you recently experienced the loss of a father figure?
    → What do you do to gain control of different situations in your life?

    While not all of these questions will be appropriate to ask each and every patient at every encounter, the point is that explicitly asking relevant questions that are specific to a male patient’s experience will not only help build trust and rapport but will help reveal the truth. It is important to remember that signs and symptoms of eating disorders may be hidden or masked by other conditions or concerns, and the patient may be ambivalent about seeking treatment. By asking targeted questions, providers and care givers show they are aware that the man in front of them may be suffering from an eating disorder.

    There are many factors to consider in a comprehensive care plan for men with eating disorders. Asking the right questions, and knowing what male-specific treatment programs are available in your area are great places to start. Some additional factors to consider are encapsulated in the WHATS UP DOC mnemonic for eating disorder care.

    National Eating Disorders Week is dedicated to heightened awareness around eating disorders. During this week and every week, let’s be sure to remember the men we care for and consider that they, too, may need treatment for eating disorders. Let’s pledge now to get more men the treatment they need and deserve.

    *The following video is a recording of a 2015 webinar featuring Theodore E. Weltzin, MD, of Rogers Memorial Hospital. The recording is a detailed update on treating eating disorders in males, includes personal insights from two patients, and is more than one hour in length. Dr. Weltzin specializes in treating males with eating disorders. Rogers Memorial hospital provides behavioral health at multiple locations in 5 states.

    Check out the following Males and Eating Disorders Treatment Update video by National Eating Disorders Association


    Have you known or cared for males with eating disorders?

    How will the information provided here help you provide better care in the future?

    Sources and Resources

    Eating disorder kills man | | chippewa.com

    NIMH >> Eating Disorders: About More Than Food

    Males get eating disorders too. Eating disorders in men and boys

    Symptoms and causes - Eating disorders - Mayo Clinic

    Get in the Know: Males and Eating Disorders | National Eating Disorders Association

    Males and Eating Disorders

    Men With Eating Disorders Often Ignore Symptoms

  • Feb 16

    Tragically, many people die from medical errors every year in hospitals.

    It’s hard to know how many. “Medical error”is never listed as a cause of death on death certificates. But according to Johns Hopkins Hospital patient safety experts in a report published in 2016 in the BMJ (formerly the British Medical Journal), medical errors are the third leading cause of death, causing more than 250,000 deaths per year. In order of prevalence, here are the leading causes of death in the US:

    • Heart disease
    • Cancer
    • Medical errors
    • Respiratory disease

    Note: Not all doctors agree with the study results, saying the study did not differentiate complications from medical mistakes. For example, a pulmonary embolism following surgery is a known complication, whereas amputating a wrong limb is an error.Still, the article brought the subject into the spotlight. Medical errors include failing to diagnose, such as sepsis, failure to rescue, surgical mistakes, medication errors, and more.
    Sometimes even Nurses Make Fatal Errors.

    Hospitals are dangerous places. But there are things you can do proactively to reduce your risk for harm.

    Family Member

    You need to have a family member or friend with you. Patients with family present at the bedside receive more attention than those without. This is my observation and seems to follow human nature. It holds staff more accountable even when it is not a conscious effort.

    Identify a spokesperson to speak with the doctors and communicate to the rest of the family. The spokesperson should avoid calling the nurse at the beginning of their shift- give them time and you’ll be better received as well as get better information.

    Personalize Yourself


    For a longer hospitalization, put pictures on the wall or bedside table. It makes you a parent or a sibling. A person with stories. An animal lover or a guy who fishes. Not just another patient in a faded gown.

    Get to know the caregivers by name and be appreciative. It goes a long way.

    Speak Up

    Ask health care workers, including doctors, if they have washed their hands. Healthcare workers go from patient to patient and not all are conscientious about handwashing.

    Using an alcohol based gel is considered the same as washing with soap and water in most cases (unless they have been exposed to Clostridium difficile (C Diff).

    Informed consent

    You have a right to informed consent for all invasive procedures. Informed consent is provided by the provider.

    Informed consent is the provider explaining the risks and benefits so you can make an informed choice. There are risks to everything, including taking an aspirin!

    Don’t assume doctors and nurses know best or are infallible. It’s your body. Surgeons may see something as a surgical problem, while medical doctors see a medical problem. Some doctors are aggressive in treatment while others are conservative. Listen carefully to the risks and benefits.
    A pulmonologist once recommended my husband have an invasive and painful procedure (pleurodesis) to keep his lung inflated. His cardiologist barged in and dismissed the notion with a wave of his hand. “Ridiculous! You’ll be fine without it.” He was right.

    Hand Hygiene

    Wash your hands. Keep a packet of hand wipes close by and do not eat or drink anything without first using them. Picture invisible spores of bacteria clinging to high touch areas such as your bed rails and overbed table.

    Many serious diseases are contracted by hand to mouth transmission (actually fecal- oral transmission) such as Clostridium difficile (C. diff) spores. Avoid touching your eyes, nose and mouth -you may unknowingly infect yourself.

    Get Up

    Mobilize. Get out of bed. When you are in bed, natural processes slow down. For example, in bed, blood pools in the vessels. Clots form in pooled blood.

    Blood clots can be life-threatening. You will most likely be provided intermittent pneumatic compression devices to improve leg circulation. But the best prevention is to get out of bed.. When in bed, flex your feet and make foot circles.

    Staying in bed puts you at higher risk for pressure ulcers, lung problems...you name it. Sitting up on the side of the bed is better than laying in bed. Sitting up in a chair is better than sitting up on the side of the bed. Walking is better than sitting and getting out of the hospital is the best way to avoid complications.

    Falls

    Wear slip-resistant socks when out of bed and always ask for help when needed. Poor lighting, an unfamiliar environment, and the effects of medications can all put you at increased risk of falls.

    Infections

    Get your urinary catheter out. Catheters are a portal of entry for bugs. Ask your nurse if your catheter is still needed, and what is the plan for it to be removed. The standard is for urinary catheters to be removed 1-2 days post-op to help prevent catheter associated urinary tract infections (CAUTI).

    Likewise, central lines, including PICC lines, are a source of infection and should be evaluated for necessity daily.

    Medications

    Keep an updated list of your medications with you so your doctor can reconcile your hospital medications with your home medications.

    When a nurse administers a medication that is new to you, you should be informed what the medication is, and the reason for taking it.If you are a nurse, be sure and read 6 Essential Tips for Avoiding Medication Errors

    I hope these tips help next time you or a loved one is in the hospital. What other tips do you have to add?

    Nurse Beth

    Leading Causes of Death. CDC. Accessed February 2017 FastStats - Leading Causes of Death

    Makary, M. A., & Daniel, M. (2016). Medical error—the third leading cause of death in the US. Bmj, 353, i2139.

  • Feb 16

    Absolutely required for admission as indicated in the Standards for Accreditation of Nurse Anesthesia Educational Programs=Admission requirements include:

    "A minimum of 1 year full-time work experience, or its part-time equivalent, as a registered nurse in a critical care setting. The applicant must have developed as an independent decision maker capable of using and interpreting advanced monitoring techniques based on knowledge of physiological and pharmacological principles"

    You need the best foundation to be prepared to succeed in a nurse anesthesia program and most importantly to become a terrific CRNA. That means the most challenging acuity patients as found in the ICU. Keep in mind that 1 year is the minimum requirement, it may not be enough to best prepare you and it may not be enough to be competitive. Do more research on the profession and educational program requirements- shadow a CRNA as soon as possible.

  • Feb 16

    Quote from CRNA, DNSc
    Absolutely required for admission as indicated in the Standards for Accreditation of Nurse Anesthesia Educational Programs=Admission requirements include:

    "A minimum of 1 year full-time work experience, or its part-time equivalent, as a registered nurse in a critical care setting. The applicant must have developed as an independent decision maker capable of using and interpreting advanced monitoring techniques based on knowledge of physiological and pharmacological principles"

    You need the best foundation to be prepared to succeed in a nurse anesthesia program and most importantly to become a terrific CRNA. That means the most challenging acuity patients as found in the ICU. Keep in mind that 1 year is the minimum requirement, it may not be enough to best prepare you and it may not be enough to be competitive. Do more research on the profession and educational program requirements- shadow a CRNA as soon as possible.
    .
    Yes, to their credit CRNA programs are still particular about experience unlike NP programs where most admit anyone who can pay the tuition.

  • Feb 15

    I believe nurses are very special individuals. Think about it. They are professionals who take care of others in their dire moments. They patiently heal the putrid wounds of some; calm the fear and hopelessness of others; tolerate ingratitude and hostility daily; endure day after day of toiling around the sick and dying. Is only natural you'll find compassionate and warm hearted beings among nurses. I have been in other professions and the contrast is clear to me.

    But because nursing is a tough job; some of us develop a thick skin. In a way, is a protection mechanism some develop to survive – you either get tough or you die. Although there is nothing wrong with being tough, some nurses can become quite aggressive and hostile to other nurses. We all have met them at some point, I surely did. But even being aggressive and assertive, nurses cannot match the aggressiveness of some bosses. Oh yes, let's talk about them bosses.

    But bosses are people too. Yes, there are reasons why nurse bosses are sometimes so bossy. But bosses also have their though fights to fight. They too must develop an even tougher skin to survive the trials and tribulations of health care. Sometimes bosses are just nurses who left the floor because they simply couldn't take it anymore. Then to find even more stress in management.

    Nurses are usually between a rock and a hard place. They have lots of responsibility, but lack the power to make decisions on their own. Doctors have much more say so in regards to their professional lay out. They call the shots, they can fire patients and are respected by most. Nurses on the other hand need to make decisions but always filtered by a set of rules created by others. Nurses must endure whatever BS is thrown at them. If you have an abusive patient, all you can do is to write a note and hope for the best. Most nurses can’t simply fire a patient or they’ll get fired.

    Nurses run the show but are told how things should run. Often by someone who is deciding for them from an office chair; people who never worked on a floor or have not worked in years and can't remember anything. So, nurses are in a pressure cooker situation. Pressure from all sides and not an outlet in sight.

    Well actually there is: and that is to relief the pressure on the least dangerous and inconsequential outlet – the young and vulnerable ones. The perplexed and scared nurslings are the recipient of a lot of pent-up anger. But why older nurses engage in this predatory and coward behavior?

    It must be their inability to change the system and claim their power
    . Their extreme frustration lead them to eat their young. The ones they should be nourishing, protecting and grooming to take nursing to the next level just got eaten for lunch. Just like scared animals – they step on their own eggs. This is unfortunate.

    If young nurses were well groomed and nurtured they would be the ones able to take nursing to the next level. Instead nurses create a culture of perpetuating the errors inflicted in them by transferring it to the young.

    Protecting the young

    Again, if you want to bully someone bully the oppressor and not the oppressed. Bully your problems and not the people who are here to learn. The bully energy is good energy but wasted and pointed in the wrong direction.

    The alternative to bullying is to preserve and protect the young: because teaching the young the right ways is the only viable way to change nursing culture. It changes things because the young always will change the world. But instead we teach them the culture of bullying. We create perfect students in the art of bullying others. Nothing changes.

    So, Mr. Bully next time you decide to torture the young, think of why you went into nursing back in the day. Bullying the young will only perpetuate the culture of abusiveness you were ounce, and continues to be a victim of.

  • Feb 15

    Sorry, posted instead of reporting your post. I was trying to get it moved to the student nurse forum for more answers.

  • Feb 15

    As I clicked “submit” I felt a sense of satisfaction, knowing that my desire to be an organ donor was duly noted and registered appropriately. Although I had previously let my family know of my wishes, making it even more official with the on-line sign up felt like the right thing to do.

    Registering to be an organ donor has become an almost effortless process with new website proliferation and making it do-able with a few clicks. Signing the back of a driver’s license is also good, but going the extra step helps ensure that nothing gets lost during a critical time.

    My renewed interest in organ donation happened because of a conversation with a friend whose son died and had previously expressed an interest in being a donor. Because of the donation, his family has the comfort of knowing that even now, 20 years later, parts of their son’s body continue to bless others.

    As organ donation has continued to grow each year, having nurses work in organ procurement has become even more important. In years past, many criteria such as cancer, age and infection made the possibility of donation seem more remote. Times have changed. There are virtual no conditions that completely contraindicate donation. Everyone who is willing should be considered a potential donor. The numbers of willing donors have not kept pace with the needs for organs and tissues. However, the use of internet and social media have greatly accelerated the pace of people willing to sign up and share their status as someone who is willing to give the gift of life.

    Jill Grandas, nurse and Executive Director for Tennessee Donor Services, points out that nursing plays a vital role in the organ procurement field, helping to make organ transplantation a reality for many. “Nurses are very supportive. I have found that in general, when nurses understand all the potential benefits involved, they are willing to bend over backwards to facilitate the process of organ donation. There are just so many positives.”

    Grandas points out that one person can potentially help almost 100 people. “There are 8 major organs that can be transplanted: heart, kidneys, lungs, pancreas, liver and small bowel, in addition to a variety of tissues.”

    Nurses that work in Organ Procurement generally start out as ICU nurses where they learn basic principles of hemodynamics and also the care of the severely injured person who is declared brain dead. Grandas herself worked in the Neuro Intensive Care for a couple of years before beginning her work with organ procurement. Now, 30 years later, she feels it is a true calling. “It is probably one of the more autonomous areas of work that you can have in nursing. You are independent from the transplant center and from the hospital but we serve as the connection or the bridge between the two. there is a tremendous amount of satisfaction in doing this type of work.”

    Grandas emphasizes that “It is very rewarding when you see the family having something positive happen from their bad event.”

    Organ Procurement nurses start out in staff positions which require them to respond quickly to the hospital (usually within an hour) if a potential donation is called in. “There is always something different. Every day is a new challenge. When the nurses are called to the hospital they help care for the patient until all the processes are in place.” The OPN has many family interactions, works closely with the physician and unit nurse followed by working with the OR and the transplant team.

    OPNs appreciate working collaboratively with nurses in the hospital. While facility nurses are not to begin the discussion of organ donation, a positive attitude regarding helping others through donation can enhance the whole process. Generally OPNs encounter lots of support when they step onto a unit to begin the discussion about donation with the family.

    Nurses who want to become specialists in helping families through this process can seek out entry level positions with great prospects for receiving specialized training as they move forward. There are numerous certifications available in this growing field, one that lends itself especially well to the technically proficient nurse who is also sensitive and willing to learn how to talk with families in crisis.

    I asked Grandas what she would want to tell nurses that are interested in pursuing employment in this specialized area, “We need people who are ready to learn and who like to employ their critical thinking skills.” She added, “It’s a great field in nursing because of the degree of autonomy that it affords.” With extra emphasis she concluded, “Above all, I would tell them to sign up on line to be a donor. They can even click to share it on Facebook if they wish!”

  • Feb 14

    Thank you everybody !!!
    I really appreciate it and I hope everyone has a great week

  • Feb 14

    Ding Dong Ditch and Kindness

    Ding dong ditch. For many those three words bring on a negative connotation, a feeling of frustration, and the thought of annoying children. Don’t be so quick to judge. Since I was a small child, random acts of kindness have always warmed my heart. I played ding dong ditch with friends, but there was never a negative intent involved. Rather we made bouquets of flowers and left them on the door step, delivered handmade treats, and even a few times left hard earned money for a person we knew was going through a hard time. The mysterious ditching neighborhood children even received thank you notes from some of the recipients.

    National Random Acts of Kindness Day ~ February 17th

    February 17th is National Random Acts of Kindness Day. According to the Merriam-Webster dictionary (2017) random means “without definite aim, direction, rule, or method” while kindness is defined as a “kind deed”. In essence, performing kind deeds with no strings attached and no expectation of anything in return. This is the time to act!

    Favorite Random Winter Act

    As I’ve gotten older, I’ve continued this giving tradition in two intentional ways throughout the year. For years, I stuffed my work locker in the emergency department with brand new winter jackets to give to homeless or less fortunate individuals in need. I never shared this with my co-workers, but rather had this little ritual that filled my heart when no one was looking.

    Then one year I was asked to share a locker. Naturally it appeared I was completely hogging the locker space, so I shared with my locker mate, Jill, why the locker was so full. A week later I received an email from Jill telling me how during her rainy night shift, she had given the jacket away. She was hoping I wasn’t going to be mad. Jill giving the coat away was like a double gift, especially in reading her words and the joy she felt by participating in this act. We are no longer locker mates, but I hope Jill is continuing on with this tradition.

    Favorite Random Spring Act

    Every Spring I purchase volumes of daffodils and designate random days when I hand the flowers out. Anyone and everyone who looks like they need a pick me up gets a few flowers. Then I hand out extras to the fast food drive thru attendant, the grocery checker, post office clerk, garbage man, greeters in businesses…you name it! One of my favorites is randomly placing the flowers onto cars and secretly watching the person find them when they return. Something about giving warms my heart leaps and bounds. I can almost feel my heart dancing and smiling.

    Ideas for Random Acts of Kindness Day…or Any Day!

    Whatever random act speaks to your heart, go out and DO IT! This world needs a little more love and caring so here are 50 ideas to get you started.

    1) Reach out to someone going through a difficult time and offer to listen.
    2) Bring in a box of old clothes to a local emergency department, women escaping a violent environment, or to a foster parent in need (get permission first).
    3) Thank a security guard or officer for being present.
    4) Tell a teacher about the difference they have made in your life.
    5) Smile at everyone you come in contact with.
    6) Deliver a verbal compliment to strangers.
    7) Donate blood.
    8) Pay it forward. If someone pays your bill, grab the bill for the person behind you.
    9) Encourage kids to call their grandparents.
    10) Offer to brush snow of the neighbor’s car.

    11) Pick up trash on the side of the road.
    12) Sign up to volunteer at a local charity.
    13) Encourage a child to be the best they can be.
    14) Look someone directly in the eyes and tell them how much you appreciate them.
    15) Babysit for someone who needs a night off…for free.
    16) Bring magazines for the patients in hospital waiting rooms.
    17) Bring in flowers and have the nurses deliver them to patients with no visitors.
    18) Send an “I appreciate you” email to someone who never would expect it.
    19) Bring to work a poster board with sticky notes and write compliments to co-workers for everyone to see. Hopefully other co-workers will add to the board.
    20) Pay for the bridge toll of the person behind you.

    21) Offer to grab something at the store for a neighbor or friend.
    22) Deliver a meal to a pregnant mom, new mom, or a family in need.
    23) Deliver treats to your local public service agencies.
    24) Leave a good book on a bus stop or airport bench.
    25) Put a note in your child’s or spouse’s lunch.
    26) Leave a gift card in front of the corresponding store for a soon to be shopper to find.
    27) Put quarters in a parking meter that is expired.
    28) Buy the meal for public servants dining at a restaurant.
    29) Deliver balloons to someone…anyone…just for the fun of it!
    30) Write a note to someone you’ve never met and let them know they are important in this world.

    31) Spend extra time loving an animal.
    32) Sign up for Amazon Smile to donate to your favorite non-profit.
    33) Buy a pizza for another healthcare unit.
    34) Do nice things for others anonymously.
    35) Bring in coffee and bagels for your co-workers.
    36) Hand out crayons and coloring books to age appropriate children waiting in the hospital.
    37) Bring in a bag of apples or tangerines for staff. Something healthy and sweet.
    38) Deliver packs of “Lifesavers” to individuals who make a big difference in your life.
    39) Ride the elevator and hand out flowers to everyone who gets in.
    40) Sign up for a run for charity.

    41) Leave a thank you note for your favorite barista at a local coffee or tea shop.
    42) Thank the fire department or ambulance crew if they visited your house this year.
    43) Leave a note or a treat for your mail person.
    44) Spend time with an elderly person who could use some company.
    45) Have your kids write cards to people who have made a difference in their lives.
    46) Thank the military via a letter or donation.
    47) Honor hospital ancillary staff via cards, food, or hugs.
    48) Deliver individual cupcakes to school teachers and administration.
    49) Make little bags filled with quarters and attach a note saying “Thanks for changing lives. Buy a treat on us”. Deliver anywhere!
    50) Give a coat or clean socks to a homeless person.

    Honor Each Other

    Honoring everyone you come in contact with, whether you do so with a warm smile, sincere hug, flowers, a thank you, or treats. Taking time to do simple things that make others feel important and special is invaluable. Research has actually shown these acts to be good for your moods and overall health.

    Together we can make the world a little brighter! What Random Acts of Kindness have you performed this year? Or what can you add to this list?

    References

    Merriam-Webster: Dictionary and Thesaurus (2017). Kindness. Retrieved February 13, 2017 from Dictionary and Thesaurus | Merriam-Webster

    Merriam-Webster: Dictionary and Thesaurus (2017). Random. Retrieved February 13, 2017 from Dictionary and Thesaurus | Merriam-Webster



close