Jump to content

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!

Member Member Nurse
  • Joined:
  • Last Visited:
  • 25

    Content

  • 6

    Articles

  • 1,993

    Visitors

  • 0

    Followers

  • 0

    Points

Deb_Aston has 31 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. Deb_Aston

    Depression. Despair. Suicide.

    Thank you all for reading my post, and also for your comments. This one was hard for me to write because I came very close to losing my only child. I don't think I could go on had that happened. @pinkdoves please take care of yourself. I sought counseling through my EAP (Employee Assistance Program) after this event to help me navigate through the guilt and pain; I also needed guidance on how to help my adult daughter climb out from the darkness. I hope you are able to find someone to talk to... just please know that you are not alone. Yes, Nursing is a difficult profession, no doubt about it! I've been a nurse for over 30 years and have had many really hard days, but I try to focus on the great days. (If you have time, look up my article on this site about the "best and worst" shifts... I'm sure you can all relate). The beauty of Nursing is that you can practice in so many different areas.... try them all if you must to find your happy place. I wish that for you all. Kind regards, Deb
  2. Deb_Aston

    Depression. Despair. Suicide.

    Dark Secrets Two years ago, there were several incidents of "jumpers" from a nearby parking garage that had occurred within a short time frame, and I couldn't get past the sadness and horror as I walked past it every day on my way to work. It touched me deeply, and I didn't even know them... but I knew of them, and seemed connected to them in some way. Each time it happened, it seemed like a dark secret no one would talk about. There was minimal information in the newspaper, and I had so many unanswered questions. There is a stigma that comes with mental illness that many do not feel comfortable talking about. So we don't. When Suicide Hits Home Something happened recently that shook me to my core; my daughter attempted suicide. She became so overwhelmed with her work in the news industry, with this relentless cycle of negativity and civil injustice, that she quite literally "broke". Her compassionate heart could not continue to write (and re-write, and re-re-write) about the horrific acts of violence and sadness in the world... that, and the tragic loss of life with the global pandemic, and the isolation of being in quarantine, was too much for her to bear, and she lost something that keeps most of us moving forward... hope. My own beautiful daughter became so depressed that she didn't want to live another day. That shocking realization is something that I was not prepared for... not my sassy, funny, bright, strong, successful daughter.... that can't be... under my own eyes, in my own house. How did I miss this? I felt like I had failed her. Subtle Changes In hindsight, I did see some subtle changes, but she was good at pretending she was OK... she stopped working-out with her virtual trainer because it was so hot outside. She stayed in her pajamas all day because didn't everyone who worked from home do that? She wasn't sleeping because she was working so hard writing for the news show that she produced. And me.... I am a Nurse, so I went to work like I always did, even under the stress of Covid. I came home late, sore, and tired... and I missed it. But thank God, I was able to stop her in time, and get her help. Yes, we have guardian angels among us. Inner Demons We have all felt sad, disappointed, and alone at one time or another in our lives. Those of us who have struggled with depression, or other high-risk factors such as loss, low self-esteem, rejection, or stress, have experienced varying degrees of darkness and despair; it’s not a fun place to be, and not everyone makes it out alive. Some have been in such a low place that they feel their only solution to overcome this immense pain and suffering is through one final extreme act of choosing death over an unbearable life. We all have our own inner demons that come out when we are at our most vulnerable. Depression is an illness that often can be mistakenly viewed as a sign of weakness, or an inability to cope with everyday life. This is just not true. The American Psychiatric Association (2018) defines depression as a medical illness that affects how one feels, thinks, and acts; it can lead to thoughts of suicide if left untreated with the right mix of therapy and medication. Death From Despair Suicide has been described as death from despair. According to the Center for Disease Control (2018), suicide rates in the U.S. have increased 25% in the past two decades and are increasing among adults aged 45-64. Among those aged 15-34, suicide is the second-leading cause of death. These are scary statistics...especially when they hit so close to home. Those of us in healthcare have seen the outcomes of an attempted suicide. My first experience as a young PICU nurse caring for a teenage girl who attempted suicide by hanging was extremely difficult; there was no happy ending or miraculous recovery for this young girl. This story was tragic, and yet it happens every day. She had gone through a bad break-up with her boyfriend, and the pain and rejection led her to self-mutilation, which didn’t dull the pain deep inside of her, so she hung herself. Her sister found her, and called 911. She was brought back to a life of vegetation. She wore a haunted look of pure rage, which seemed to be her only facial expression when “awake”. She had just enough brain activity to continue medical interventions. I still think about her from time-to-time and I wonder if she ever found the peace that she was looking for so long ago. I truly hope so. What Can We Do? What can we do to prevent our loved ones from choosing this ultimate act of despair? First, we need to be able to recognize the signs and symptoms of depression and not be afraid to ask if they need help or want to talk… or even if they have ever thought about hurting/killing themselves. We need to support better medical coverage for mental health and pre-existing conditions; we need to prevent those who have mental health conditions from being able to legally purchase a firearm; and last, and most important, we need to support them and not judge them. “There, but for the grace of God, go I”. Timing is everything, and if the pain and despair are recognized early enough, perhaps a life can be saved. Linkin Park wrote a beautiful song about suicide called One More Light (2017). The irony that one of the writers, Chester Bennington, committed suicide a year later, speaks to his state of mind and intimate understanding of the effects of suicide for the ones who are left behind to try to heal from this great loss. If you, or someone that you know, are having thoughts of suicide, please seek professional help; call a friend or family member, or call the Suicide Hotline: 1-800-273-8255 depression despair suicide. Aston.docx References American Psychiatric Association (2018). What is depression? CDC. (2018). Suicide rates rise sharply across the US, new report showswashingtonpost.com Linkin Park. (2017). One more light
  3. Deb_Aston

    The Calm After the Storm

    You can’t calm the storm, so stop trying; what you can do is calm yourself, the storm will pass. (Timber Hawkeye) This has been a year of being tested on many levels… emotionally, physically, and mentally. We have all been under quarantine for several months during the Covid 19 pandemic, and most recently, the great racial divide has come to a blistering head, and we are faced with the harsh reality that even in 2020, all men and women are not being treated equally. There is a deep pain that has been centuries in the making, and countless events of injustice that have been normalized for far too long. How are we handling the stress and loss of control that surrounds us on a daily basis? I, for one, am struggling. I find myself feeling anxious from the minute I wake up and listen to the Morning News, to the minutes that I finally lie down in my bed, trying to shut my brain off from the noise that is somehow silent on the outside, but deafening, and relentlessly loud on the inside. But it is the time in between those hours, when we are at work, and trying to do the best that we can to carry on with our lives, that can be the most difficult. We struggle to block out the “noise” and strive to make a difference with our patients and their families during a 12+ hour shift. We also have our own families who need us to keep it together, and function in a somewhat “normal” capacity, during a time where nothing is “normal” and hasn’t been for a while. That storm To say that I am a little on edge, well, that may be the understatement of this really challenging year. Unfortunately, as a nurse, we have to try to remain calm when everyone around us is screaming. Yes, during an emergency we focus on the task at hand, and trust that our training will automatically kick in when it’s necessary; that’s the easy part. The hard part is when we are not in an emergency, and we “lose it” over something that may not have triggered us so easily before … maybe over an error with the schedule, or sitting in traffic, or scrolling through social media and reading a post that angers you to the core because you thought your friend was smarter (and better) than that…yeah, it is in those moments where you start to have your own personal “storm”, and it isn’t pretty, and it definitely doesn’t cast a beautiful rainbow in the aftermath. This kind of storm can get you into some hot water if you are unable to reel it in. Loss of control and our response I think we all manage stress, fear, and anxiety differently, but for some of us, loss of control is one of the most difficult obstacles to overcome; at least it is for me. I’ve always told my daughter that you can’t control how other people act, but you can control how you respond or react … that advice is on point, and easy to say, isn’t it? However, it is not always easy to do. Sometimes we don’t know how we will react until it happens to us … we can respond differently depending on the circumstances of the moment. For example, we may be able to remain calm and composed if we are in a great mood and slept for more than six hours … or if we are working with our favorite nursing team… but maybe the words (themselves) are not the issue, but the tone is what rubs you the wrong way? Maybe you just want people to care more, and be more accountable … like you… maybe that would make things different and more palatable? What can I do to prevent, or calm the storm? I’ve been doing some research and soul-searching to identify ways that I can try to improve my own ability to manage stress, and react in a calm(er) manner when faced with a situation that makes me want to scream a few expletives at an unsuspecting person. I sought advice from two of the smartest people that I know, and they gave me great insight into actions that I could do (immediately) to improve how I respond to either (a) prevent the “storm” from happening or (b) how to de-escalate it if that ship has already sailed. One of them is a friend and colleague, Dr. Mark Stein, who shared with me some things that have worked for him, and are based on conjecture, bitter experience, and frustration with other approaches; they are: Identify what the current problem is, and determine what you want to happen to fix it Find common ground in whatever the dispute is Nobody likes being told they are wrong, even if you prove it with facts (especially if you prove it with facts, I may add) Imagine being them, and try to determine what they are saying, and why they are acting that way; in most cases, they are afraid, and in over-their-head with the problem, and they want someone to help solve their difficulties Offer to help figure out the problem with them Provide a compliment, or kind word to them about something that they did that was good Lastly, and he couldn’t stress this enough, bring in doughnuts from a good bakery, “not just Dunkin’”; sharing food breaks down barriers, and has always worked for him when interacting with a potentially difficult person or group Dale Carnegie (1981) believed that the only way you could get someone to do anything was to (somehow) make the other person want to do it. Carnegie (1981) also quoted John Dewey, a great American philosopher, who believed that the deepest urge in human nature was the desire to be important. I believe that with this kind of thoughtful insight into human nature if one can take a few minutes to process some of the issues that have led to a dispute, and strategize how best to address it, in a positive manner, the outcome would be far better than if you allowed yourself to show anger or frustration. In the end, no one really “wins” an argument; according to Carnegie (1981), the only way to get the best of an argument is to avoid it altogether, because even if you “win”, you still “lose”; making someone feel bad, or inferior, will cause resentment, and that is not a battle worth winning. My last thought on this subject Try to be mindful of some of your own control issues and triggers; not everyone has the tools in their toolbox to manage extreme periods of stress and environmental obstacles that are out of their control. We are in unchartered waters when it comes to coping with being bombarded by tragedies and heartbreak in the News and many social media outlets on a daily basis. FACT: We need to take time to embrace silence and focus on being mindful of our own needs, while showing empathy to others. No one truly knows what others are going through in their personal lives. Please be safe out there, and may tomorrow bring us closer to peace, equality, and justice.
  4. Deb_Aston

    Ask Me If I'm Safe At Home

    Thank you for sharing your struggles in this beautifully written article... this hits very close to home for me and I feel your pain. Having a relationship with a narcissistic bully is extremely painful. I got out from my verbally abusive marriage, and I'm glad that you did too. Wishing you all the best.
  5. Wow...I'm sorry that happened. Unfortunately, I have seen similar situations.
  6. 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!
  7. 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.
  8. 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.
  9. 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!
  10. 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.
  11. 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
  12. 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!
  13. 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!
  14. 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.
  15. 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!
  16. 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!
×

By using the site you agree to our Privacy, Cookies, and Terms of Service Policies.

OK