jaelpn

The ever-changing doubt of medical decisions to best suit our healthcare needs When COVID first began, we thought we had a handle on being able to get over this little setback in healthcare. The uncertainty felt vaguely like an outbreak of a norovirus that comes and goes after a few bad weeks. Yet, we were not prepared for the outcome of what became like a domino effect. I work in a skilled geriatric facility. We were safe at the beginning. We felt invincible; we played it safe. That is, until that one time ... "I have covid." The physical therapist, who just had a recent procedure at the nearby hospital, had worked with seven residents. She started to show symptoms and then she tested positive. Of course, back then, I don't think we really had rapid tests available immediately, so she had to take a PCR test that seemed to take a week to get results back. By that time, the virus is running rapidly. Soon, the seven people she worked with had gathered together for meals, had talked to one another as they passed each other, heading to the activity room. Soon, we are testing several residents. We become numb to taking temps and 02 sats every shift. My heart dropped every time we had another positive case. I never realized just how dangerous that first round of COVID was. When their appetite really wasn't much to begin with, try having your taste and smell completely turned off. Absolute torture to try to feed someone mushy food with no appetite, with no taste and smell. The pleasure of eating is really a gift. I didn't realize it until I had my own COVID positive test. I went to work as normal, and I went to grab a cup of coffee. Hmm ... maybe this coffee isn't as strong as it should be? I take a sip ... it feels like hot water on my tongue. Immediately, I knew ... I was another victim. I'd like to say my covid was a wake-up call. I didn't realize how easy it was to catch it so quickly. I know I had used my PPE correctly, but what did I do wrong? Was it because when I was at the desk and charting, I pulled my mask down? Who have I just exposed? Social media made it feel like it was just a simple flu that would go away as quickly as it came. People were talking about the politics of this virus on local news; everyone had their own opinion. It felt like even my own doctor was being influenced by what social media was posting. Playing it down as if it was just a mere flu. COVID honestly was a huge fear of mine. I didn't want to spread it to my daughter, my husband, or anyone I had contact with. When we were in the outbreak, we ended up losing half of our census. They died slowly, each day never knowing who else was going to go downhill. One sweet lady, I'll name her Jeanne, was on her deathbed. She had a corner room. We moved her bed over to the corner, opened her window and her family had to say their goodbyes through a 6-inch opened screened window. "Nana, we love you." It was truly heartbreaking to know that her family could not hold her hand, kiss her forehead gently and ease her into her resting place in Heaven. We have been through COVID for about two and a half years now. I recently tested positive again, even after being vaccinated and boostered. I still wore my N-95 mask at home and slept separately, but knowing what I know now versus what we went through then, we have better grips on what to do. What symptoms are we going to see? How mild is this case going to be? My first time getting COVID, I lost my taste and smell for three weeks. I had no appetite but ate a sausage and egg biscuit because it was different textures and something to chew on. Once my sense came back, it was altered; like a year of altered food diversion. Coffee smelled like it was burnt. Protein meats tasted spoiled. It was hard. I was interested, however, by how social media downplayed some of this as if we were making up our symptoms to give big pharma another boost in revenue. We have grown as a nation in how we handle this virus, but do we really know how long we will remain fighting this every year with different rules and regulations that seem to change all the time? Is there any consistency in healthcare anymore?

The resilience of our spirit has been shaken from it's sanctuary. What once was, is now ever changed. A silent tear escapes even the most hardened spirit, Wondering, hoping, lingering onto a promise. Our masks are hiding our frowns, our smiles, our uncertainty. Our eyes are all that you see. Is there a way that we will be able to feel the embrace of our loves ones again? The windows of our eyes will soon see, that this moment in time will not be an eternity. One day at a time, seconds to count, hours to live, minutes til night. Although we feel like we're drowning, our faith will save us all. Each passing moment, a laden heart strives to beat. This is only a fraction of time, a testiment of our breath. jaelpn 5.11.2020

I have a resident that was a big golfer back in his day. One night, as I knocked on the bathroom door and entered, he was sleeping in his wheelchair. I gently woke him up and assisted him to the bathroom. As I was washing him up, he said, "Wow, I never had a caddy wash my butt before!"

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"One of my patients really gave me a hard time today. I just needed to blow off some steam and let the wind blow through my hair. You don't think our son will mind, do you?"

One evening I was shooting the breeze with one of my residents. We were just talking and laughing and having a good old time. Then she said, "Stop, stop, you're gonna make me wet my depends!"

I have a 95 year old resident that often falls asleep in the bathroom. When I knocked, he didn't answer. I entered and gently woke him up. He was a little dazed. I assisted with his pericare and helped him into his pjs. He looked at me strangely, and then said, "I never had a caddy that would go to such great lengths to assist me, especially to wash my butt." He was an avid golfer in his younger days and well... I was the caddy he never had! Haha :)

"I survived that first year." I believe those words were what I whispered quietly as I finished my first year of being a Nurse. ...and also being a first time mother. It seems to go hand-in-hand. You can prepare, study, read other's experiences, but until you actually experience that first year... you can only hope it's a smooth transition. My daughter was born February 11th, 2015. When I had her, I had 7 years of nursing experience under my belt. I haven't been in the hospital as a patient since I was in grade school with a fractured arm. Instead of being the nurse caring for a patient, I was the patient. It's kind of crazy how you can go into the bathroom, pee on a stick and come out with these 2 pink lines...and the world stands still. It's in a blink of an eye that your life changes. It is like when you are waiting for that final "Pass or Fail" on your nursing NCLEX.... and you see "PASS", you realize all the hard work and dedication was well worth it. The way you are in labor, you struggle through the labor pains, the back labor, the hard pushing, the burning... "oh she has a full head of hair!" ...and you are pushing with all your might to be able to see that precious face you have waited to see through all the months of pregnancy.... you are hoping, dreaming and ready to take on this new adventure. And finally, that moment arrives.... you give your last ounce of strength, whether it be labor (or your last amount of strength in nursing school) and out comes the most remarkable gift. When my daughter was placed on my chest, the world truly stood still at that moment. Those precious hands, those toes, her big eyes taking in the new world around her... that moment will always be the most cherished. So when my first year of being a nurse is thought upon, I remember the struggle. You are in that learning phase, yet are set free. You get a few weeks of orientation and then are on your own. Being in the hospital for a few days is one thing, but once you place your baby in the car seat, and put that key in the ignition, you are set free. She is now completely you and your husband's responsibility. The struggles of sleepness nights, having to wake up to breastfeed and finding that latch was difficult. But as she learned how to latch on, and I learned to find a position comfortable for the both of us, it became easier and easier. Maybe this is why, it too, is called "Nursing." Much is the same as when you are in that first year of being a nurse, you are learning how to become comfortable with yourself, your judgement and how that effects the people you are taking care of. There are milestones in parenthood just as there are milestones as a nurse. It's all about caregiving. Not going through the motions... but actually C.A.R.E. giving. You make the best judgement you can, and sometimes reaching out to others is okay. 2nd opinions are sometimes needed, and yet your intuition kicks in. You want the best outcome not only for your baby, but for your patient, as well. When my daughter was still in the hospital, her bilirubin levels were high. It scared me as a new mother (and nurse), because I was just ready to go home. I was scared- did she have to stay in the hospital longer? ....did she need to be on bili-lights? So I was reaching out... and kindness of others was what got us through, praying for us, praying that the next blood test would come back with better results. I tried everything, from placing her closer to the window to let the sunlight in... feeding her constantly to get her little system going. Then the nurse comes in. You linger on every word she has to say, because she is that link between you and the doctor. "Do you want to hear the good news or the bad news first?" ...being the optimist, I chose the bad news... because whatever the bad news is, there is good to follow. "The bad news is, in 2 days you have to bring her back in to see the pediatrician." ...."The good news, you are being discharged. Congratulations on being a new mommy. She is beautiful." Watching her learn to roll over on her side, to being able to sit up on her own, learning to crawl and cruise around the furniture all on her own brings a smile to my face. Those first few independent steps she takes catches my breath. Then she falls. Then picks herself right back up and tries it again. She is learning just as we are learning. It is all about taking baby steps. You don't become a nurse overnight. You take baby steps. You hit milestones. You don't give up- you try, try again. Life is all about the experiences, and you know what? It's all worth it. We lean on others in the tough times, and we give each other hope when it is needed. It is what brings moms, and nurses, TOGETHER. We lean on each other through the good and bad. It is just in our nature. It is our way of nurturing.

Doctor, I notice your nose is a little longer today. Did you tell another patient, "This shouldn't hurt?"

No problem Brian, I completely understand- after my evening tonight, I am pretty sure I dropped my marbles

This was a great contest this time around- thanks to all that voted. I know my buddy Joe would be proud :) I enjoyed reading all the articles. Has anyone received anything in their paypal account yet?

It is unfair- it's a very gray area. I thought that this is WAY out of scope for one CNA to screen another CNA. I am going to talk to the administrator tomorrow to clear the air. I would like a written policy handbook and an actual what to do when something happens- if someone gets a papercut and asks me for a bandaid am I suppose to run and get a drug kit and make that person pee in a cup and write an incident report? How many people are going to want to NOT report an incident because they may test positive? The employee wasn't wanting to go to the doctor- I was busy with my rounds and she just kind of mentioned so and so bit her but didn't draw blood or break skin. Not a big deal- alzheimer residents bite, hit, pinch, squeeze, pull hair, etc all kinds of stuff- so every time that stuff happens we have to write an incident report? I don't get it. I don't want to jeopardize my employment or feel like I have done something wrong when I really feel like I need to be better informed, and have something in writing. Thanks for the reply back!

Last week the financial/business manager instructed me and a few CNA's ("teamleaders") that with any employee incidents, they have to be urine drug screened before they can go see the doctor for workman's comp. I work in an assisted living (I am an LPN) - So I think something qualifying as an incident (a slip and fall, trip down the stairs, resident breaking your wrist...) would justify a visit to the Dr. So while I was doing my rounds the other day, a CNA came up to me and said, "so and so bit me on the breast, she didn't draw blood or break skin, I'll call and let her know. She never called but filled out an incident sheet and placed it in this person's mailbox. She didn't go to the doctor and was fine. We work in the dementia/memory unit and so you expect the pinching, biting, scratching, hitting, etc as you would with any scared, dementia related resident. So, I get called down to the office the other day and this financial/business manager handed me a sheet and said she was writing me up for not calling her and doing a urine drug screen on this employee. Do you think I was in the wrong for not doing a drug screen on this employee? Are LPNs really responsible to perform drug screens on employees? This is the kind that you are to sit right outside the door, allow them to not wash their hands until you have the cup in your hand, etc (I think it's called chain in command?) I have never been written up before and I was literally tearing up before I even was able to walk down the hall to my office. You work so hard to do the best that you can for the residents and then you feel like all that hard work is worth nothing when someone tries to bring you down.

"When they say it feels like a full-moon night, they weren't kidding! No wonder they tossed their stethoscope up here!"

I use to think that faith was enough- that if I had enough faith, I could accomplish anything. Faith is something that I think can lead us into the belief of being able to have a stronghold on life. When the tough gets going, we start to see that cloud of darkness roll in. I have always been known to be a Christian, but the closer I get to thinking I know who I am, or what I am and believe in- things change. One minute I am feeling this complete satisfaction of life as if some light of clarity has suddenly turned on inside of me. The next moment I am wondering how I am able to even survive another day on this earth. There are nights that I have trouble sleeping; I'm just staring up at the ceiling with my mind going a mile a minute. I'm sure there are many other people who do this as well. I just start thinking about things in life. One thought always crosses my mind: I am going to die. We all know it's coming, there is no escaping the reality of what human life becomes. We exist, we live and we die. It's something no one really wants to talk about, yet we are all swimming in the same ocean of life. I try to wrap my mind around the concept of death but it's hard. I see death often since I work in the medical field. It's not that shocking to be doing the final preparing of a body before the funeral home straps the body to the gurney to be prepared for the last viewing before the body is buried six feet under. Sounds kind of morbid, doesn't it? What happens to our souls after we die? There are so many different religions, so many different beliefs. How do we know that our religion, our belief- is the "right" one? I grew up going to a Methodist church- so from a young age, I was told I was a Christian because I believed in God and sang all the church hymnals, was baptized and did all the things that a young christian person should do. The older I got, the more I thought about how my faith never really started until I lost my faith. I had gone through the phase of depression and lost what faith I had in life. It was much easier to just stay in that dark depression and not feel anything toward life (like a numbness)- but the deeper I got, the harder it was for me to feel anything toward life. I don't really remember how my faith came back, but I knew that I needed to find some kind of happiness in life. I'm sure most people know about God and the story of Jesus, Noah's arc, etc. As a kid, I remember reading from the children's bible- seeing all these colorful pictures of the arc, the cross where Jesus had died for our sins, the heavenly angels playing the harps on this big white puffy clouds. The more I think of it as an adult, the more it seems all that stuff was written like a fairy tale. We don't want to think of what is -next- after our death so we want to fill it up with something that seems too good to be true. I don't believe there are coincidences in life. I believe there is a purpose for everything that happens. We may not know it until after our hindsight of the experience, but I think there is a reason for all the good and bad things of the world. After my father's death at the age of 59, I tried to close my eyes and pray. It was hard...I was angry that my dad had died so young, and maybe I just wasn't in the right state of mind to pray when I was angry. I eventually overcame the anger and was in that accepting stage. A few different times I had dreams of my father- almost like I could touch him. It brought a lot of emotions- knowing that he is only as far away as I let him be. We are stuck in these bodies for a long while- these awful, hard to maintain at times- bodies. My dad had a lot of stuff wrong with his heart and lungs- it just caused him an early death. But death isn't as negative as it sounds- it's kind of like putting a beloved pet down because you don't want to see them suffer anymore. God knows the person is suffering, the person's body isn't responding the way it should so he puts the body to rest and their soul lives on in the dimension of the universe for which we can't see with our humanly eyes. There is not a doubt in my mind that there is something "more" ...there are too many miracles, too many things to think we were all created from some "big bang" ...the simplicities of a blooming flower, the sounds of birds chirping, the way the stars shine brightly in a clear midnight sky. That is where my faith comes in. There is just too many beautiful things in the world to think that we humans could make it all up. The miracle of birth- how we all are so different and yet we all have two eyes, ten toes, ten fingers, etc. How awesome is it to see a child born to this world- and life to begin once again. I may not be the picture perfect Christian. I know I'm not even a good enough human to deserve this life; to be able to see what life brings forward. I know that I am, however, full of faith. Faith has taught me that no matter how hard life gets, no matter the good from the worse things that happen in life, faith will carry me through. I've heard the saying that someone has faith the size of a mustard seed; althought that's a very small amount of faith- it's something that can carry you through. We all need faith- I hope that wherever the wind may blow, no matter how difficult life comes- faith can reach us all. I have faith there has to be a better tomorrow; why? Because without it, there's no use in living. I'd say faith is enough- enough to give us Hope.

Has a topic been announced yet for the article contest? I'm sure everyone is looking forward to reading more articles. I know I have enjoyed reading many of them!

"i heard that mr. jones was having a bad night last night...and he had the nurse fetching all kinds of stuff for him last night... it'd be nice for once if we could be man's best friend in our field of nursing."

Late nights usually accompany me with the television on low as I randomly read through a magazine or book, once I am in my soft pajamas. I fall asleep quicker when I take a few hours to unwind. Then I turn on the fan, close my eyes and cuddle in my bed with warm blankets surrounding me. This is the typical night for me; nothing exciting. ....and then there are those thoughts that I just so happened to think about as I heard on the commercial about starving children. About those poor dogs that need homes. Kids without running water, a decent education. Barefoot in 30 degree weather. I couldn't imagine a life so horrible. Here I am- a 27 year old who has the rest of my life in front of her. I'm disgusted with myself. While I am a nurse and do take care of my residents and do my best in this life, why am I not taking a stronger pride in humanity? Where is my compassion?I have never wished hell on anyone. Those people who are out on the streets because they are down on their luck- wouldn't just a little part of my check give that person a heads up? Wouldn't just a little bit of friendship or conversation make for a different emotion? Why can't the world see this?Why do we look down on the people who need us the most? No one is perfect- no one deserves to be bullied, or even talked down to. We are all living life with the greatest of struggles. We need to be more kind and deserving of others. Be patient- walk in their shoes for a mile and you will realize that not everything is peaches and cream. I cry myself to sleep many nights thinking that I wished I had more to give, I wish that my heart could pour out to these people that need to hear what needs to be said. God never meant for anyone to suffer, not in the ways that we do. Suffering emotionally and spiritually is enough to make even the boldest person break down in tears. God loves each and every one of us, no matter what we have done in this life. We have the choice to either ignore it or embrace it. For just one day- I am going to give it my all, in hopes that what I will have in return is a changed heart.

Have you ever had your thyroid levels checked? I had overwhelming fatigue for a while and just couldn't get enough energy to get my day started. My blood test came back and I found out I have hypothyroidism. I now take one pill a day for the rest of my life- but it has made all the difference in the world. I was diagnosed in 2008 and I have been full of energy, have noticed that my life has changed since then. Just a thought :)

I had major pain in my arches and heels. I could barely get up in the morning and walk to the bathroom without hurting. I had gone to New Balance and the guy measured my foot and I got an insert to help with arch support. He even said that I had a slightly wider foot than the normal shoes so he gave me a shoe with a slighter wider width. I loveeee my new balance- and I'm on my feet for hoursss. I know walmart has those kiosk that have the orthopedic inserts and you can stand on it and it will show you where you have the most pressure on your feet. Anyhow... good luck with finding a decent pair of running shoes for work!

I believe in you- you passed the LPN course, your clinicals and you succeeded. There were a few weeks after I passed the course that I realized that with all that studying in nursing school, I was burnt out. They teach you test-taking skills; read each question slowly and do your best to feed out the ones you KNOW are wrong. You will see questions on the NCLEX that you just have no idea and might as well throw your hands up in the air and give up! DON'T. Think with logic; ask yourself if you were in that situation, what does your nursing gut tell you. I, too, walked out of that small classroom, and decided that I failed. I failed I failed I failed.... then, 48 hours after taking the test, I logged in and saw PASSED... I was finally an LPN. Underneath all the stress, studying guides (it's only a guide to teach you strategies of test taking and some guidance on what sort of questions are going to be on the nclex), you have to believe in yourself. Get a good nights sleep, eat a hearty breakfast (or a snicker bar, whatever )and sit down and relax. Trust in yourself. Don't let fear get in the way. Tell yourself you can DO this. I believe in you, and I am sure there are others that believe in you too.

Hospice will hire CNA's/LPN's/RN's... my boyfriends mother (who has an associate) just got hired on as an RN staff nurse. So good luck to you!

When you become a nurse, sometimes you just get a "gut feeling"... sounds to me like he may have had a TIA... transient ischemic attack. I've had residents that have gone unresponsive for a few minutes- cold, clammy, eyes just sort of glazed over. "Something" was going on- it's always better to do what is in the best interest of the pt- was he a dnr, full code- these are things you have to learn with experience. I have been an LPN for 2 years now- and I'm still learning. But you don't want to risk having your resident go into a cardiac episode... even though it's a nursing home, LTC... does not mean that the resident doesn't deserve medical attention when needed. You never know where a blood clot could travel. So don't worry about what the other nurses are saying- you stand your ground, be proud of what you are doing and know that you did what was the best approach in patient care. Just ignore the talk behind your back... that happens a lot and you just have to feel that you are doing your best as a nurse.

Thanks for all the input; it makes me feel a little better. I know that it is assisted living and that it is suppose to be more of a homelike setting- but sometimes I would worry about the residents that ARE a full code; but I guess that is just the way things are. I have performed cpr ONE time... but that was while I was doing my clinicals for my EMT- we were in the ER and a man came in, full code, crashing, and I got to perform bag-valving and chest compressions for seven minutes... I think the Dr. had already declared the man pretty much on his way out, but he was intubated anyways, and the dr let me and my other clinical partner perform cpr.... ugh... the sound of ribs about made me puke! But it was a great experience.... something nursing school never actually taught me! In fact, nursing school didn't really teach us ANYTHING remotely relating to what to do in a real trauma!

Does anyone here work in Assisted Living? We specialize in alzheimers/dementia. I was just wondering if any of you have a crash cart... or if it's legal to get away with not having any sort of AED?