Nurse_Advocate

I agree with you dsigney! There is a lot of negativity on the nursing forums...and I have an opinion as to why. There are a trememdous amount of things in nursing that the nurse gets no choice about. For example: **no choice (or very, very little choice) in which patients the nurse gets that day (daily "assignment") **no choice in the timing of patients (it seems as soon as one discharges they're on the phone calling report on the next one) **even though the acuity of patients can change at any time, there's no adjustment made in the number of patients the nurse has to take (in other words ratios rule, not acuity) **administration doesn't care about what the nurses have to say **requests of administration for change fall on deaf ears These are just a few areas that the nurse has "no choice" in. There are tons more. When "choice" is taken away from you, you are likely to feel like a victim. You may become negative, anxiety ridden and depressed. Talk about stress! I am an advocate for nurses. I care about my fellow nurses. I think we have a tremendous power source that we haven't tapped into. Personally, I've tapped into this power source in my own nursing career. The results are amazing. Asking for what you want is very empowering. I blog about this. It's listed under my profile. God bless!

These post are several years old. Thankfully the staffing ratios have changed in California. It's now 5 (maximum) patients to 1 nurse. This is a beautiful thing. However, depending on acuity, things can feel really hairy, really fast at any given moment of any given day. That's why I practice the Law of Attraction in my nursing career. As you can see in these posts, nurses are really good at complaining. There is a huge aspect to nursing that leaves the nurses and the caregivers of these really sick patients feeling very overwhelmed and helpless. Nurses (and other HCW'S) feel like victims much of the time. Their loyalty to their patients takes over and, in the end, they don't take care of themselves. The focus becomes very, very negative and it becomes a self-fulfilling prophecy. A negative feedback loop, if you will. I have found relief through incorporating the principles of the Law of Attraction into my nursing practice. I ASK the universe for what I want help with and I get it! I focus on gratitude and what's going right during my day. It makes all the difference in the world. I write about solutions to nursing stress on my personal blog. I share the system that I have had great success with. Take a peek. Believe me, it's better than the alternative! My blog is listed via my public profile. God bless my fellow nurses!:loveya:

Here's what I do with my stresses whether they be from my work life or my home life or just things that may become a worry for me. I write about them free-hand, just kind of "hash things out" and get in touch with the sources of my stress. From there I get a clear picture in my mind of what I specifically want help on. And then I ask for the help! Using a 79-cent notebook, I list my desires in affirmative, present tense sentences. I am asking God for help in attracting what I want. But you can think of it as asking your Creator, Jesus Christ, Allah, Buddha, God, the universe, your Higher Power or ANY belief system that you practice. Some of the parameters I would write about if I were you would be: I am focused during class. I am in tune with the subject matter. I easily comprehend the subject matter. I score well on my tests. I have all the help and resources I need. I score "B's" or better on my tests. I have the proper study partners for me. I quickly get through each subject. I retain what I study. I make good progress with each passing week. I remain calm. I have a positive attitude about nursing school. ETC., ETC., ETC. Short, direct, simple sentences. Skip lines between sentences. Ask for what you want...pen to paper is powerful...I blog specifically about tools nurses can use to counter nursing stress. There's a little more to it, but the MOST important part is listing what you want in writing. There is more information at my blog, listed in my profile. Good luck to you! Keep up the good work and keep asking for what you want in life!:loveya:

I don't think there's a nurse alive that can't relate to what you are saying about sleeplessness and anxiety before a shift. Here's some of the things that I do. First, I acknowledge that anxiety is the state of "living in the future" about something. For me, it usually involves a feeling that somehow my needs won't be met (in that future scenario) or that there's just not "enough" for me in the world. (not enough support, help, resources, breaks, wisdom, back up, etc., etc.) My solution? 1) Write about it. Write a letter to "the universe" and hash it out. 2) Talk about it with a professional (and I DON'T mean an M.D. Perhaps a counselor of some type. Release some pressure. Don't do it alone! 3) Have some spiritually nourishing (or just plain entertaining) reading materials right at your bedside and start reading if you can't sleep. 4) Affirm what you need in your life with pen and paper. An example of how I do this is: "I have all the help I need at work. I build teamwork at work. I serve my patients well at work. I practice good self care at work. I take regular breaks. I am efficient at work. I leave work on time regularly." I don't know about you but these are SOME of the things that I can potentially worry about enough to lose sleep over. So basically, I take all my worries and I ask "the universe" to specifically help me with those things. Believe it or not, it helps tremendously and is somewhat empowering! Good luck! I blog a lot about stress relief for nurses. Stop on by. My blog is listed in my profile. :)

Yes. We absolutely need an order to place an NG tube...and in this case there was an order on the chart for 2 days but it HAD A LOOPHOLE...it said, "Place NG tube if patient continues to have nausea and vomiting"...unfortunately the nurses kept medicating her with just enough anti-nausea meds to keep very large emesis at bay so she was just having small throw ups here and there (and those don't count I guess?). When things like this happen, I remind myself that I have choices in my life. I can make whatever I want happen in my life if I'm willing to do the daily baby steps required...it's my sincerest wish to inspire other nurses to create their ideal lives too!:typing

To their credit, in general, the doctors at our hospital ALWAYS actually lay eyes on their patients (even if it's just from the doorway???). It's pretty rare that they will not look in on the patient before writing their progress note. And also to their credit, they seek out the nurse (we carry RN cell phones at all times) to ask how the patient has been doing that day. I LOVE when the doctors do that. That way I get to clarify their chicken scratch orders too before they leave. That's just wrong to think that doctors aren't even looking at their patients at all...that's just wrong:(

HOLY COW! You guys! I knew you could relate but it really, really gets hairy when you hear about doctors ignoring nurses' multiple calls to them on behalf of these patients who are throwing up with huge bellies and patients dying! That's horrible! The very first thing I said to the night nurse after I got report was, "Did you put the NG tube in?" and then she started her song and dance about nausea, only small emesis and meds. (And she's a relief charge nurse!) BUT remember it wasn't just her who was ignoring the obvious, there were doctors and other nurses too! I suppose walking rounds are part of the solution but our unit is so crazy at change of shift I guarantee you we'd all be getting out 1 hour late on a daily basis!!! Not sure if that's do-able. (they are doing a pilot on it on a different floor at my hospital, however, yikes! I'll keep you posted):) Again, I repeat, if you're not confident in something (for me it's IV's - I confess!) - then ask for help...no shame in that...ever! You guys are awesome. Much appreciated.

I walked into one of my patient's rooms yesterday and I see this 70 something year old woman who has been on the floor for 2 DAYS who is extremely nauseated. She has a history of cancer and she's admitted for small bowel obstruction...her stomach was so distended that she looked 8 months pregnant. The orders on her chart were to insert NG tube for increased nausea and vomiting. The night nurse reported some "small emesis" last night and having to medicate her with anti-nausea meds a couple of times. I immediately explained to her all about an NG tube and that it would take away her nausea and that the doctor had ordered it for her IF she continued to throw up and feel nauseated. NO ONE HAD DONE THIS YET. She was actually very receptive and agreeable to it. I put the NG tube in and IMMEDIATELY got 2000 ml output. (by the way, I always bring another RN with me in the room during NG tubes and we work as a team to educate, help and encourage the patient through the procedure!!! In this case I had my 2nd semester nursing student in the room too!!! good experience for her to have!) Her husband was in the room and got "treated" to a show also. It actually couldn't have gone smoother and she tolerated it very well...and the relief for her...oh the relief! Anyway!!!! Seriously Folks!!!! This lady suffered for 2 days because, FOR WHATEVER REASONS, no one wanted to put the NG tube down...come on nurses, when something is so obvious, do the right thing...and if you don't feel confident in your skills OR YOU JUST WANT BACK UP get some help doing the right thing...that's how to advocate for your patients. Needless to say, we had a great rest of the day and she even was able to take a peaceful nap in the afternoon. We got another 800 out the rest of the shift! Even when things aren't so obvious to you, if you have a hunch or an intuition or things aren't adding up to you or you have a feeling or concern about something for your patients, RUN it by someone...this is what advocating is all about. We are the chosen ones who have stepped up to the plate to nurse our fellow human beings...I believe we are given hunches for a reason! Lots of love to you all.

Yes!!!! a thousand times yes!!!!! That is what I love too. Since becoming a nurse 5 years ago, I've basically fallen in love with seniors. (some can be very difficult for a variety of reasons, but overall, I love taking care of them...I better because I routinely have 4 out of my 5 patients in their 80's!!!) As a side note, over the years, I've made a point of pointing out elderly people to my kids and commenting about how "cute" they were. The point being for my kids to #1) Notice older adults, #2) Appreciate them and #3) be aware of their welfare (open heavy doors, offer them your seat, etc.). All my efforts have paid off because my 15-yr-old daughter chooses to do all her (required) volunteer hours at the local senior center and LOVES IT! And my two teenage sons have actually pointed out "cute" elderly people without being solicited by me at all. Basically, as my kids say, "Old people grow on you, don't they Mom?" I couldn't agree more! and I know most of my fellow nurses feel the same way!

I am constantly amazed at what my patients teach me! How the human will to live is on display if I only care to look for it!

Some people don't feel good unless they are "living in the problem" -- tattling feels like complaining to me and some people love to complain. They like to take a warm bath in it. The thought of being pro-active in their own lives or thinking of solutions for their floor or participating in committee meetings would NEVER occur to them...no they're happy tattling and complaining. Example: Post op (urology surgery -- reconstructed ureter and stent placement, etc.) comes to the floor. Patient has been on pain meds. at home for a long time...tolerance. Within seconds of interacting with her first nurse, she FIRES her first nurse and now the CN has to reassign this "DIFFICULT" patient to someone else... guess who?... Me! The patient is now loudly crying out in pain, the husband is getting freaky, and the first nurse is spending so much time re-enacting and complaining about the whole scenario that I almost couldn't get her to shut up long enough to give me report!!! Finally, I had to cut her off so I could go assess the patient and get her medicated... Tattle Tails live in the problem...they thrive there! It's for those reasons that I'm taking steps to create a different (non-nursing) life for myself! I am pro-active and I'm crystal clear about what I want. :typing

I can relate on a grand scale! I have a 17 (almost 18!) y/o son and a 15 (almost 16!) y/o daughter and a 12 (almost 13) y/o son (born June, July & August) --------so I know what you're talking about! I'll tell you what I do...I close the door. My 17 y/o is going to college next year (we're not sure which of 2 UC's yet) --- if he doesn't know how to clean up, or should I say, if he is UNWILLING to clean up his room on his own then he deserves to live in the mess. The kid is bright...a great test taker...did well on SAT's...well respected by his peers and teachers...gets decent grades (could do a little better) --- so what does he need me cleaning his room for??? My son is gonna have to get sick and tired of it himself. I've taught him how to clean and donate and throw away stuff in his room before...he KNOWS how, he's just not ready. I repeat...I close the door! take care of yourself nurses, (I'm reachable), --Theresa:wink2:

I don't have advice for you. but just some thoughts... you must protect your feet. We are nurses. Our feet are our livelihood. We are on our feet for 13+ hours at a time. Walking in pain, compensating in your gait can stress your other joints to the point of further injury. Only you know the answer to how serious you feel this situation is...it sounds like you have a good doctor (who did the first surgery...) it sounds like only you know your answers but your manager sounds horrid! I'm reachable...be happy to talk. --Theresa

We know that stress causes cortisol levels to rise which raise our blood pressure, raise our blood sugar levels, increase our lipids, etc. Blah, Blah, Blah. The point of this article is not to teach you something you already learned in pathophysiology class. We know that high stress levels can cause weight gain and we know that obesity complicates every disease there is. Obesity has been linked to higher cases of breast cancer, etc. As nurses, we KNOW all this stuff. Let's not go there right now. Instead the message of this article is to talk about the emotional price of high nursing-related stress in your life. Nursing stress is so unique. It's practically impossible to explain to non-nurses...that's for sure! How do you explain what it feels like to have your pager go off for two different patients at the same time? One is in severe pain and one is throwing up. Add to that scenario "a transport tech" arriving on the floor asking if your pre-surgical patient is ready to go to surgery because the anesthesiologist and surgeon are waiting downstairs. Yikes! You didn't get the checklist done yet! Multiply that scenario several times an hour for 12+ hours at a time and you've got nursing stress. Nursing stress mounts so quickly that it leaves you speechless with friends and family. The thought of describing what you go through during your work day becomes so exhausting that you just don't do it. You don't tell your friends. You don't tell your family. You may find yourself becoming emotionally shut down to a certain extent because you start to hold stuff in. Have you ever wondered, "Am I depressed and I don't even know it?" You may find the answer to that question by examining what you do on your days off. After a brutally stressful day at work, it is not uncommon to hear a nurse describe her day off like this, "All morning, I could still hear my pager going off and the monitors too. I stayed in my pajamas until the afternoon. All I had energy to do was zone out on TV and eat." It's a matter of life and death to find healthy outlets for the nursing stress in your life! When the thought of picking up the phone and talking to a dear trusted friend to "relieve some pressure" becomes too much for you to handle, there may be a problem. Perhaps you used to refer to it as a "mental health" day, but when all your days off look like this, there may be a problem. In general, isolation (not talking, stuffing with food, not socializing) can be warning signs of too much nursing stress in your life. Beware of "shut down" mode. Conscious separation is a problem. Conscious unity is an answer. Here are some of the things that can work to combat nursing stress:Talk about it. Talk to your fellow nurses, your charge nurse, your department director, your friends, your family, your mentors. If you don't want to talk about details, at least talk about your feelings and what you plan on doing to change your circumstances.Utilize mentors in your life. (spiritual, mental, emotional, physical, entrepreneurial)Walk/hike with your spouse or friend regularly each week.Participate in groups with similar interests as your. (Don't just attend. Talk!) The power of a group cannot be underestimated.Take advantage of nutritional vitamins and supplements.Eat healthy snacks (remember low carbs/high fiber/high protein).Watch your sugar intake (there are alternatives to high sugar coffee drinks!).Blog on different subjects.Join Online Nursing Forums and participate.Write and journal.Share your writing and journaling with people you trust.Go on a 30 day Mental Cleanse (be extremely selective with what you "take in" mentally).A very wise woman once gave a speech to a group. She said that she had come to a turning point in her life and wanted to make a change. The single most important thing she did to change her life around was this: She started to "LIVE OUTLOUD". She ended her silence. Nurses, if you do nothing else, start living outloud!

The person they have precepting you sounds psycho. They are probably "burnt to a crisp" and resenting the added responsibility of having to train you...what a shame. I wholeheartedly agree that you should get your Nurse Educator involved...tell her the story that you told us. Get your charge nurse involved. Tell her the story that you told us. This is the kind of thing that happens when nurses don't take care of themselves and let themselves get burned out beyond recognition! Inquire with HR or the nurse staffing representative what other floors and shifts are hiring...I know you may not want to change from L&D but learning your options can be helpful! Talk to your Department Director and let them know the situation described above...something's NOT right with your preceptor... I suppose if you want to follow chain of command talk with your CN first, then the Nurse Educator and then the DD...but do it! If it's any consolation I had a preceptor from hell when I first started on my med-surg floor (5 years ago). Long story...but what I did was make an appointment to meet her at her home to get my "skills" checked off because we never had time at work... Long story...but what I learned about her was that she was divorced, she had a very over-bearing perfectionistic father, she resented her ex-husband and NEVER got along with her step kids, she was having a falling out with a co-worker and she lived alone with her dog...and she was very lonely! I'll never forget how her attitude changed with me after that...talk about helpful and supportive...like a different person. You hang in there and Get Vocal! Take care of yourselves nurses! --Theresa