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Deb_Aston MSN, RN

Peds, PICU, Peds Onc, Nursing Leadership

Strong nurse advocate; would have liked to meet Florence Nightingale... I think we would get along famously!

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Deb_Aston has 30 years experience as a MSN, RN and specializes in Peds, PICU, Peds Onc, Nursing Leadership.

I have been a RN for 30 years and have worked exclusively with the pediatric patient population; my background includes Peds/Adolescents, PICU, Peds Surgery/PACU, Peds Hem-Onc/BMT, Quality Improvement, and Nursing Supervision. I think Nursing is a wonderful profession that provides many opportunities to try out the many specialties/sub-specialties in healthcare.

 

 

 

Deb_Aston's Latest Activity

  1. Wow...I'm sorry that happened. Unfortunately, I have seen similar situations.
  2. If the PCTs or UAPs are not licensed providers, they should not be allowed to administer medications, or "assess" a need for BP meds (or any meds for that matter). They are not trained to make clinical decisions. If these actions are being allowed, it puts the entire organization and more importantly, the patients who trust the organization to safely care for them, in danger. I would share your concerns with the Chief Nursing or Medical Officer, and if that doesn't work, report your concerns to the Dept of Health and Human Safety. Good luck!
  3. Zero Tolerance Many organizations are focusing on implementing a zero-tolerance policy for bullying behavior that has historically been done at the staff nurse level. New nurses enter the workforce, eager to begin their professional journey, and then are faced with the harsh reality that “nurses eat their young”. They are met with criticism and intolerance; sometimes even cruelty. We have all gone through it at varying degrees; most of us developed a “thicker skin” until we proved ourselves to be competent, and were gradually accepted into the team. It is not an easy process and some nurses don’t even last a year; they decide that this was not what they signed-up for, and opt to transfer to another unit, another organization, or even decide to leave nursing altogether. When bullying or incivility is tolerated in the work environment, job satisfaction and retention are affected (Lachman, 2014). Smart organizations are proactively focusing on retention, and are inviting staff nurses to become part of the solution through peer mentoring and retention committees. Upper Level Administration Incivility But what if the bullying is being done from above, at the administrative level? Nurse leaders are not all created equal. There are many levels to leadership roles, from a Manager or Supervisor, to Chief Nursing Officer, or Vice President of an organization. To presume that hospital administrators and nurse leaders are above bullying behavior is a great falsehood; it happens all the time in competitive organizations. I’ve witnessed it firsthand, and it left quite an impression; it makes one question the integrity of the entire organization. While some leaders “talk the talk” about transformational leadership and anti-bullying initiatives, they do not always “walk the walk” when it comes to their own behavior to other managers and leaders. The environment can become hostile, and many mid-manager level leaders are unable to speak-up for themselves out of fear of making a mistake, and concern over job security. While nurse leaders must try to follow the vision and goals of the organization to implement changes that ensure patient safety and improve outcomes, they still face obstacles on a day-to-day basis that can be challenging to overcome. The most justifiable and well-intentioned suggestions can fall on deaf ears from the powers that be when one is working in an environment that doesn’t foster collaborative change. Even very experienced leaders can feel pressured by upper administration to perform tasks that are above and beyond realistic expectations, often without help or support. Are Our Jobs Safe? When someone from administration decides that the organization wants to “go in a different direction”, no one’s job is safe. The Union does not protect managers, and leadership jobs can be filled quickly, with enthusiastic candidates looking for a new opportunity and career advancement. In fact, other leaders from within the organization can often begin to sense when a colleague is being left out from the “inner circle” and start to distance themselves from you in fear of being connected to the outcast. You begin to wonder when and how you will be “let go”, or asked to resign with reputation intact, so it is easier to find another job, as if it was your idea to leave instead of being fired. Sometimes, a small severance package may be offered to make the dismissal somehow less offensive. Change is Needed! If bullying is being tolerated at the administrative level, what options do we have? Casale (2017) states that if incivility is not being addressed in the workplace at the highest level, it projects a general acceptance of bad behavior that provides the bully with a degree of power and control. For change to occur, administrators need to model, and commit to, a culture of respect and civility to ensure a healthy work environment (Casale, 2017). References Casale, K.R. (2017). Exploring nurse faculty incivility and resonant leadership. Nursing Education Perspective, 38(4), 177-181. Lachman, V.D. (2014). Ethical issues in the disruptive behaviors of incivility, bullying, and horizontal/lateral violence. MedSurg Nursing, 23(1), 56-60.
  4. Deb_Aston

    I Am A Sober Nurse, But Only for Today

    Thank you for sharing your story... it takes a lot of courage to be so honest and transparent about your struggles with alcohol. Wishing you all the best in your daily fight to stay sober.
  5. Deb_Aston

    CBD Oil for Older Adults, What is Known and Unknown

    Really interesting article! I am hearing about the uses of CBD almost every day for pain management and insomnia; even for pets with anxiety. Thanks for writing about this current topic!
  6. Deb_Aston

    The Importance of Best and Worst Days

    Thank you so much!
  7. Deb_Aston

    The Importance of Best and Worst Days

    Thank you! I appreciate your kind words and I am glad that my article helped you this morning! :) Nursing is really hard work, and I know that it is important to always look for the silver lining, even in (especially in) those really difficult shifts. All the best to you!
  8. Deb_Aston

    The Importance of Best and Worst Days

    Close your eyes and think about the worst shift that you ever survived; I use the word "survive", because after such a shift, one can feel like they have been through hell and back in what seems like a never-ending 12.5 hours... who am I kidding, we are nurses, it's more like 13-14 hours! My worst shifts weren't the "busy" ones that happened because we were short-staffed, didn't get a break, or got swamped with admissions; those happen all the time and we (just) "get through" them. No, the worst shifts stay with you; you remember how they made you feel... sadness or regret, self-doubt, anger, helplessness, or frustration... or all of those things piled into one really crappy day. We remember the painful things; it's not by choice. As nurses, we often bear witness to horrific things that occur every day, in every city or town. We see car accidents, victims of violence, drownings, child abuse/neglect, etc. We try to help in any way that we can; when we can't, our heart breaks because of our limitations. My worst days still live within my mind; I remember the bruised, emaciated body of a little boy who was kept in a cage in his adoptive parent's basement as we tirelessly worked to resuscitate him; we did everything that we could, but it was too late. I remember caring for a teenage girl who attempted suicide by hanging, who was brought back to a life of complete debilitation. I remember providing end-of-life care to a young girl who fought a courageous, but impossible, battle with cancer, and once she peacefully passed from this life, with her parents and siblings at her side, her mother's heart (literally) stopped beating, and we had to immediately (and unbelievably) go into life-saving mode, call a "code blue" and start CPR on mom, right outside of her deceased daughter's room. We brought her broken heart back, whether it wanted to continue to beat or not. I still think about that family many years later. I will never forget that worst day and the lesson it taught me that one can truly die from a broken heart. Now...take a breath, close your eyes, and think about your best day at work...did it inspire you to be a better nurse, or a better colleague...or a better person? The best shifts are not the ones that are uneventful, or dare I say, "quiet". No... the best shifts are often unexpectedly extraordinary. A best shift is created when you are working with a great team and all the stars are aligned in your favor for a positive outcome. I remember one of my best days; I was an active responder during a Rapid Response that turned quickly into a full code. We did everything in our power to re-start a life, but we soon became acutely aware of the high probability that we may lose our patient. During the final pulse check, we all looked up at the monitor in complete silence...a rhythm suddenly appeared, and pulses returned. We were all in utter disbelief, but we gratefully accepted the gift from above that will sustain us for an entire career. The best shift becomes that "crazy, unbelievable" story that you share with one another, forever bonded as witnesses of a true miracle. The worst and best days are important because they make us who we are; they define our actions, attitudes, and our experiences. We learn from them; they make us (more) human, and better nurses. They also create stronger and more united teams because best and worst days connect us in a way that most other professions simply cannot. I wish you all best and worst days that will give you the strength and empathy that you need to be compassionate, grateful, and kind to one another.
  9. Deb_Aston

    I have no words. I have a thousand words.

    I loved this article. It rang very true for me, especially after my father passed away in August while in hospice care. Fortunately we were able to care for him at home, but the support and care that we received from the hospice nurse was amazing. She helped us to keep my father comfortable until the very end. Thank you for your words and for your kindness and compassion. You are a very special person.
  10. Deb_Aston

    Last Time for Everything

    When I heard the song "Last Time for Everything" by Brad Paisley on the radio, it literally brought me to tears because I clearly remember the last time that I spoke to my Dad on the morning that he passed away; I told him that I loved him, and he responded as he always did, "I love you more". At the time, I had a strong feeling that it was the "last time" because he was so ill, but just two days before, when he was having a good day, we sat in the living room together and talked about the usual "stuff" and ate dinner together...I had no idea that it would be the "last time" we did those simple, everyday things. "Things" that later end up becoming cherished memories. The regret is that you wish you said more, stayed longer, and listened closer. The moment when I remember that I can't pick up the phone to call my Dad to share some news, or talk to him about my day, ask his advice, or laugh about something funny... makes me miss him terribly. Those "last times" become exponentially important when they are no longer a possibility. That's when it all becomes very sad...and very final. Nurses are acutely aware of how, in the blink of an eye, a life can be taken, often without any warning. Terrible, tragic things happen all the time... being involved in a car accident on the way to work, enjoying an evening out at a Jason Aldean concert, dancing in a nightclub, even just walking around town... the world can be an unpredictable, unsafe place. Our country is experiencing trying times, and anyone who watches the evening news knows that no one is safe from the potential of harm. Life is cut short for those who are lost, but it is the survivors who have to learn to cope with a new reality and resulting pain. While it is difficult to overcome, it is also a sad fact of life. "No one gets out of life alive" has been quoted often. The meaning is that we all (eventually) die, and the advice shared is to "not sweat the small stuff", or not to take things too seriously... which is really hard to do. There are those who are lucky (or maybe more enlightened people of faith?), who are able to not waste time or energy on the draining, exhausting act of worrying; I'm sure they are (much) less burdened with stress, negativity, and insomnia! Nurses, in particular, are faced with the difficult task of providing comfort to those who have lost someone. They become the survivors...the obituary reads "he is survived by his wife of 55 years, his children, and grandchildren". Nurses are at the front lines; they know the words to comfort and console. And sometimes there are just no words to be said, and a hug or a kind gesture are the only thing we are able to give to those whose lives are forever changed. What words can ease the pain of a parent who loses a child? There are none that exist. It is unspeakable; unimaginable. Nurses stay strong in times of pain and grief because they must; it is a part of the job. Our patients and families look to us for support and guidance to help them through the worst day of their lives. If only there was a way of "knowing". I think that there should be a text message notification from God giving us a heads-up to pay close attention and take it all in, because that's all we will have left... memories. White Light Alert: "This will be your last day with your father; make it meaningful". Most times we aren't aware of the timing and significance of a moment that could be/is "the last time" for something....last time speaking to your loved one, last photo, last phone call, last Christmas, last birthday, last time saying "I love you", last time walking your dog... fill in the blank. There are so many "firsts" and "lasts" that we rarely recognize it until it's too late. There are many "things" that Nursing has given me, but the most profound has been the gift of perspective. Whenever I have had a rough day, or feeling bad about something that hasn't worked out the way that I wanted, I walk into my job on the Pediatric Hematology-Oncology/ Bone Marrow Transplant unit and I am suddenly reminded that my life really isn't that bad afterall... my child (who is now an adult) is happy and healthy, I am physically and mentally able to care for those in need, I get to leave the hospital at the end of my shift, and I have a great job that constantly challenges and inspires me to come back for more the next day. Reference Paisley, B. (2017). "Last Time for Everything". Retrieved from
  11. Don't feel you are stuck anywhere... I went right into Pediatrics when I was a new grad and have been in the Peds world ever since in some capacity or another. Many of my friends who went the Med-Surg route got burned out quickly; it's not for everyone. I would still meet with someone from HR who might be able to help you be successful in another unit. Or start fresh in another organization that gives you the tools and resources to succeed, maybe in the Nursery to start out (very hard to hire into the NICU without nursery or meds experience in my opinion. Those babies are much too fragile!) Don't feel trapped. That 5-year mark is not written in stone anywhere. Where there is a will, there is a way. Good luck!
  12. Oh no, I am so sorry. It sounds as if you lost all of your confidence, which is probably why you are feeling so bad right now. We have all made mistakes, especially as a new nurse. The important thing is to try to find a mentor or "buddy" at work who can be your resource person during your shift if you have a question, or need support, or a 2nd opinion/another set of "eyes". Never forget that you are a part of a team. Trust me, teamwork can help lighten the load; it will also help you feel more sure of yourself through this learning period. To avoid other med errors, always make sure that you are checking and rechecking orders, patient, doses, etc. Ask another nurse to verify. None of us are above asking for help. Even the most senior nurse doesn't know everything and has to look things up or ask a friend. I don't know what kind of contract you are under, but it might be helpful to make an appointment with a representative from Human Resources who can help guide you on what your options are...first and foremost, patient safety should always be a primary concern for organizations. If you are not succeeding, that means that they have failed you during your orientation. Some places have year-long nurse residency programs that meet monthly so new nurses can vent and share stories and experiences. Trust me, there are many options available as a nurse. If you don't love bedside care, you can consider working for a pharmaceutical company or patient equipment company, you can consider Quality Improvement or database coordinators (many trauma and OB registries are managed by nurses)...so many choices. I hope you find your confidence. Good luck!
  13. I agree with many of your responses. I have been a single mother to a young child, and I also had to work nights. In a way, I imagine that you probably feel like a single parent also, carrying so much of the workload by yourself. It is very hard... trying to be alert while caring for your child, who needs you 24/7, and then going to work all night to care for patients is very difficult. Nursing is physically, mentally, and emotionally draining. You have a license that you worked very hard for, you don't want to cause harm while in your role. You also need to care for yourself, because others depend on you. I hope that you find a good solution. I also recommend a PT or PD job(s); some organizations offer weekends only for more money... maybe that can work and your husband can care for the baby on the weekends, or other family / friends can help? I wouldn't have been able to do it without the help of my parents, I was fortunate in that respect. Good luck! Take care.
  14. Deb_Aston

    Advice please with new job?

    Dream job opportunities do not present themselves everyday. A PT job can often become a FT job; I say go for it! Good luck!
  15. I would highly recommend going back for your graduate degree...it provides you with many new opportunities for clinical practice. My Master's degree is in Administration also, however you can take an Education track if you love teaching. I'm sorry to hear that you were assaulted by a patient; unfortunately, that is happening much too often now, even in the pediatric world where I work. If you are unhappy, consider other available positions; maybe transferring to another speciality or unit (or organization) is just what you need to be inspired. I have worked in many different areas and each has taught me so much about the different roles of nursing in healthcare. Good luck!
  16. I hear you, it's not for everybody! Night shift definitely has it's pros & cons. I know many night shift nurses who love the camaraderie and low key workflow (compared to days, that is). It is hard on the body though, you really have to take care of yourself physically and mentally. Good luck!
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