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SafetyNurse1968 ADN, BSN, MSN, PhD

Oncology, Home Health, Patient Safety

If I were in charge of the universe, there would be staffing ratio laws and unions in every state and you'd get written up for NOT taking your breaks.

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SafetyNurse1968 has 20 years experience as a ADN, BSN, MSN, PhD and specializes in Oncology, Home Health, Patient Safety.

Kristi Sanborn Miller RN, PhD, CPPS, HNB-BC is A Patient Safety Specialist. She just finished her doctorate in nursing at East Tennessee State University. She is an Assistant Professor at the University of South Carolina -Upstate. She is also a mother of 4 and loves being in the woods of Western North Carolina, when she's not obsessing over patient safety research. Kristi is a board certified professional in patient safety, and a published author. She has over 10 years of experience in nursing in areas like oncology, integrative health and home health with over 20 years of experience in education.

SafetyNurse1968's Latest Activity

  1. SafetyNurse1968

    Nursing shortage is BS

    Anthony, have you thought about nursing education? We are desperate for male nurse educators. You can get your MSN online, get it paid for and then have a wonderful job! I love my students, my hours, my pay, summers off, and the joy of knowing I am changing nursing by teaching what I believe in. Let me know if you are interested - I'm happy to mentor you or find someone else who will!
  2. SafetyNurse1968

    Do Male Nurses Face Gender Bias in Nursing Education?

    I teach a course called Digital and Information Literacy and we've been talking this week about how differently people behave online as opposed to in-person. I'm reading this last string of comments and thinking about how we seem to assume the worst in each other - and it's easy when you can't see the person's face or their body language. When we assume the worst, then our fight or flight response kicks into high gear, our hearts pound and our breathing gets shallow and our brains even short circuit a little bit. The comments fly back and forth and no one feels understood. The more we type the less we seem to communicate. Can we agree to disagree and perhaps give one another the benefit of the doubt? Try assuming the person making comments is good hearted and that we are all just doing our best to communicate in an imperfect world. I know that makes me a bit of a goodie two-shoes, but if the costume fits, I gotta wear it. Ya'll are awesome for caring so much. Thank you.
  3. SafetyNurse1968

    Do Male Nurses Face Gender Bias in Nursing Education?

    I disagree – we now know that gender is nonbinary, meaning it falls on a spectrum. The chance of being born in the US with external genitalia that doesn’t match the textbook definition of “male” vs. “female” is the same as being born a red head (about 1 in 1000). A person born with anatomy that isn’t immediately identifiable is at risk for being placed into a gender category that doesn’t match how they feel. Young people who don't fit our outdated ideas of binary gender are at much greater risk for sexual violence and self-harm (just to name a few challenges they face). As nurses, our code of ethics demands that we respect the inherent worth and dignity of all our patients regardless of personal feelings so that we can provide the best possible care for everyone. In this article, I have attempted to do that, though I realize as a cis-gendered person (I identify as the gender I was born with), I come with my own inherent bias, despite my best efforts.
  4. SafetyNurse1968

    Do Male Nurses Face Gender Bias in Nursing Education?

    Thank you for reading and commenting. The answer lies in what you can objectively determine. It's not always possible to determine that a person who identifies as male, was born with female genitalia. You often can't tell by looking at a person with their clothes on that they are transgendered, and you can't ask (at least in polite society) for them to undress. All we can go on is how the person has decided to present to the world. My understanding of working with transgendered folk is that if they present as a certain gender, then that is how they would like to be perceived. What is more confusing for us cis-gendered folks is when we see someone and we can't tell immediately what gender they are. It's tricky because it's not polite to ask, so we have to do our best to be respectful and open minded. I think these folks might experience the most bias of all...but that's another article!
  5. SafetyNurse1968

    Do Male Nurses Face Gender Bias in Nursing Education?

    I feel like DeeAngel is saying that if she has a choice and can plan ahead, she does not want a male nurse. I don't think it's fair to assume that this would also extend to physicians, since as a previous poster pointed out, the relationship with the physician is often very close and evolves over a long period of time, thus trust can be built.
  6. SafetyNurse1968

    Do Male Nurses Face Gender Bias in Nursing Education?

    Oh dear! how could I forget Malik? OP brain is turning to Jello....
  7. SafetyNurse1968

    Do Male Nurses Face Gender Bias in Nursing Education?

    As always, thank you for correcting me! male nurses on shows I mentioned: Grey’s Anatomy: Tyler Christian Scrubs: Paul Flowers ER: had no luck here- help me out! I’m old, so this was the one I watched all the way through. Do you think the Hollywood ratio matches reality? According to Becker’s, the female:male ratio of RNs was 10:1 in 2015, but it varies widely by state! Hawaii and Nebraska have 5:1 ratios, while NC & SC have 15:1 ratios. https://www.beckershospitalreview.com/human-resources/gender-ratio-of-nurses-across-50-states.html
  8. SafetyNurse1968

    Do Male Nurses Face Gender Bias in Nursing Education?

  9. SafetyNurse1968

    Case Study (CSI): I’m too tired to walk the dog…

    Thanks so much for reading and commenting - here's the solution! This patient has Addison’s disease caused by damage to the adrenal glands as evidenced by the abdominal CT. This primary adrenal insufficiency is confirmed by the Rapid ACTH stimulation test showing minimal elevation in cortisol with high levels of ACTH. The cortex of the adrenal gland has been damaged most likely by the latent tuberculosis the patient experienced. This has led to symptoms that relate to low levels of corticosteroids including glucocorticoids which support the body converting food to energy and help the body respond to stress; mineralcorticoids which maintain sodium and potassium balance and keep blood pressure normal and androgens which maintain secondary sexual characteristics like axillary hair. Symptoms often develop so slowly they are ignored and include extreme fatigue, weight loss and decreased appetite, darkening of the skin, low blood pressure, salt craving, hypoglycemia, N/V/D, abdominal, joint or muscle pain, irritability, depression, body hair loss and sexual dysfunction in women. Untreated Addison’s disease can cause an Addisonian crisis as a result of stress, so people with addison’s (a lifelong disease since the adrenal glands don’t grow back) may carry a glucocorticoid injection kit with them and wear a medical alert bracelet. Patients are typically prescribed Cortef (hydrocortisone), prednisone or methylprednisone to replace cortisol. The hormones are given on a schedule to mimic normal 24 hour fluctuations of levels.
  10. SafetyNurse1968

    Do Male Nurses Face Gender Bias in Nursing Education?

    I'm so grateful when folks read my articles and comment. Disagreement seems to make for a more interesting conversation! I completely appreciate what you said about the "nursing shortage" - I came so close to not including that comment in my article. I agree with you, Jednurse. The day nurses are paid fairly and safe staffing ratios are instituted in all 50 states is the day the "shortage" will end. To address your other concerns, as a person who identifies as female, I really wish nursing were more balanced gender-wise. I would like to experience my profession with more diversity and balance - I think it would be more interesting and more fun to come to work. I hope we can agree that a diverse work-force makes for better patient outcomes, and a more collegial and stimulating workplace. Thanks again for reading and commenting.
  11. The next time you’re at work, look around. How many of your fellow nurses are men? I teach nursing and in a class of forty students, I have only three students who identify as men. None of the forty faculty members at my school of nursing are male. Back in the 1960s, only 2 percent of nurses were male, but now the number has risen to 13 percent.1 Why is nursing so female-centric? HISTORY We were taught in nursing school that the first nurses were male caregivers in Ancient Rome, tending the sick and dying during the Crusades. Male nurses were also found in the Civil War in both the Union and Confederate armies. The shift to an all-female workforce didn’t begin until the Army Nurse Corps (ANC), established in 1901, banned men from serving as nurses. It wasn’t until 1955 that they commissioned the first male officer.2 MEDIA You may have seen a movie called Meet the Parents, in which Ben Stiller plays Greg Focker, a male nurse who perpetuates stereotypes that women are nurses and men are doctors. If you look at Grey’s Anatomy, Scrubs and ER, the stereotypes continue. We might see a female doctor, but never a male nurse. In a survey of male nurses, 70 percent stated that gender stereotypes are the main barrier to entering the field of nursing.1 Male nurse respondents indicated they were influenced by the misperception that the profession of nursing is not “appropriate” for men. CHALLENGING MASCULINITY In an article in American Nurse Today, David Foley shares some of his experiences as a male nurse. “The pressure to create a masculine identity within a historically female profession proves overwhelming and they [male nurses] flee for the operating room, emergency department or intensive care unit.” Male nursing students may face questions from family and friends about choosing nursing and may face challenges to their masculinity because women are traditionally seen as nurturers, while men are in more dominant leadership roles. Foley shared a story about a student who was actively discouraged from going into a less technical discipline in nursing with comments like, “You’ll never be accepted,” “Why would you want to make your life so hard,” and “What’s wrong with critical care? You’ll make more money.”3 Edward Bennett, named 2018 Student Nurse of the Year by the National Black Nurses Association, said, “I’ve definitely gotten pushback for being a black male nurse. Other people look at me like, ‘why would you want to be a nurse when you can be doctor?” Bennett continues to advocate for changing misconceptions by reminding prospective male nurses that, “You work with your hands, you think critically and you advocate for your patients every day.”4 Male nurses face a particularly steep challenge in obstetrics and OB-GYN. Even if they overcome stereotypes about who should pursue this field of nursing, often they cannot obtain access to patients. As an instructor I have seen it happen many times – a woman giving birth or having a pelvic exam doesn’t want a male nursing student to observe or care for her.3 In a survey of 462 undergraduate nursing students in Canada, male students demonstrated significantly lower scores on the efficacy subscale, suggesting that some men experience feelings of marginalization and discrimination.5 SOLUTIONS According to the IOM report, The Future of Nursing: Leading Health, Advancing Change, we must find a solution. Men provide unique perspectives and skills that are crucial to the profession and to society as a whole. We need to place a greater emphasis on recruiting men into the field. We know that patients are more receptive to healthcare providers of similar cultural and ethnic backgrounds.1 Male patients may feel more comfortable discussing certain conditions, especially those related to sexual and reproductive health, with other men, than with women. The World Health Organization identifies the “men’s health gap” – men visit the doctor less frequently and are less likely to ask questions or bring up concerns during appointments. “Having a male nurse could help open them up” says Bryan Smith, president of the American Association for Men in Nursing.6 The nursing shortage is another reason to recruit men. The president of the American Assembly for Men in Nursing, William T. Lecher, states that “The shortage of the future will likely not be solved unless men are part of the equation.”1 Elias Provencio-Vasquez, a Robert Wood Johnson Foundation Executive Nurse Fellow, shares that when he was met with resistance from some female patients in the maternity ward early in his career as a student at the University of Texas, in El Paso, “We overcame that by presenting ourselves as students, and our faculty members were very professional and very supportive."1 Bennett recommends creating pipeline programs for male students at predominantly African American high schools to diversify the profession in multiple ways.4 THE AAMN To encourage more men to join the profession, the AAMN conducts outreach, challenging local chapters to reach as many male middle and high school students as possible through classroom visits, career fairs and more. The AAMN also offers an award to the best schools for men in nursing to recognize programs that have made efforts in recruiting and retaining male students. Award winners include Nebraska Methodist, Duke, Goldfarb, New York University, Rush, Rutgers, Vanderbilt and West Coast University. In addition, the AAMN enlists members to guest lecture at nursing schools. Only 6 percent of faculty are men. Having a lecture from a male nurse can have a powerful impact on male students who are feeling isolated and alone. “Just seeing a male being successful in nursing, even though it seems like something so small, can really trigger a sense of belonging.” says Smith.4 Nurse educators and preceptors must acknowledge that gender bias exists. We need to refrain from gender-biased language and teaching practices that may discourage male nurses from embracing a career in any of the specialties of nursing. WHAT DO YOU THINK? I’d love to hear from male nurses out there – what has your experience been? Did you find support when you needed it? Do you have ideas for how we can recruit more men into nursing and remove some of the misconceptions that are preventing a diverse workforce? Read Gender Bias in Health Care to learn more about gender bias in health care. REFERENCES Male nurses break through barriers to diversity profession Men in Nursing: History, Stereotypes, and the Gender Pay Gap How to Avoid Gender Bias in Nursing Education Bohanon M. (2019, January 8). Men in nursing: A crucial profession continues to lack gender diversity. Sedgwick, M. G. & Kellett, P. (2015). Exploring masculinity and marginalization of male undergraduate nursing students’ experience of belonging during clinical experiences. Journal of Nursing Education, 54(3):121-129. American Association for Men in Nursing.
  12. I have asked a fellow faculty member for access to their PowerPoints and exam questions, and they have refused. I'm a new faculty member, teaching pathophysiology for the first time. I've been teaching for almost 25 years, 10 of those in the field of nursing, so I feel pretty confident in how to go about creating materials for the course. There are two other faculty members teaching the course who have been at the school for many years. I approached them, asking if I might see their materials so I would know if I am on the right track - am I teaching at the right level? The faculty keep referring me to the syllabus and the course outcomes, which I am already using to design my test blueprints. Here is an example of why I am nervous: I was prepping to teach acid base (using the syllabus, the course objectives, the textbook and textbook PowerPoints as guidelines for my lecture, while adding my own flavor and flair to it -I like to throw in videos, sample test questions and case studies). While I was prepping for this content, I asked a senior nursing student about her memories from the course and she told me she is still using the tic tac toe method and how great it was that she had been taught how to solve acid base problems in path. I almost had a heart attack - there was nothing in the syllabus, powerpoints or textbooks to suggest that I go to that level in a pre-nursing course. I spent many hours revamping my course to include acid base problem solving. I never had to take path... I don't have a solid idea of what a pre-nursing student needs to get from this course...My insecurity isn't from a lack of understanding of WHAT to cover, it's confusion over how DEEP to go...what level? I've always shared everything I create with anyone who wants it, and I've never had faculty at other institutions refuse requests in the past. I've spoken directly to the faculty member who is the course coordinator and here are the reasons for not sharing: 1. I might copy their stuff 2. I need to create materials to match my own teaching style 3. I might give her stuff to the students and/or the students may share her test questions with each other 4. They don't trust me because they don't know me 5. They've asked other professionals whom they trust and they said that sharing test items and PowerPoints is not best practice. CONUNDRUM: I'm still baffled - I've looked through the literature briefly and can't find anything to suggest that sharing test questions and PowerPoints is not best practice. With the NCLEX as the end game, it seems important that all the students in the program get a similar experience in our course. As a solution, I sent a copy of the most recent test I wrote and asked them to review it for me. I've also suggested that the instructors for the course might get together and write some exams in a collaborative fashion. I'd love to know what you think? Do you share? If so, what? Why or why not? Do you have any research to back up your position on sharing? I've written to the NLN to see if they can direct me to someone who might have an answer. In my doctoral education I recall reading multiple articles and books about the importance of collaboration, but I'm looking for specific research on best practice in nursing education regarding sharing of materials, most specifically, test items and PowerPoints.
  13. SafetyNurse1968

    Case Study (CSI): I’m too tired to walk the dog…

    Awesome! Thanks for playing!
  14. SafetyNurse1968

    Case Study (CSI): I’m too tired to walk the dog…

    Hey there fearless CSIs! I have more information for you! Lab and imaging results just came in - check them out and be sure to enter your guess in the private Help Desk! Laboratory Test Results (Fasting, drawn at 9:00 am) [only abnormal or borderline labs are presented]: Na 125 meq/L K 5.3 meq/L Cl 96 meq/L BUN 20 mg/dL Cr 1.2 mg/dL Glucose 54 mg/dL Cortisol 3 ug/dL ACTH 902 pg/mL UA Specific Gravity 1.016 Rapid ACTH Stim test: Pre cosyntropin cortisol 2.0 ug/dL 30 min post cosyntropin cortisol 1.9 ug/dL Imaging: Abdominal CT scan revealed moderate bilateral atrophy of the adrenal glands
  15. SafetyNurse1968

    Case Study (CSI): I’m too tired to walk the dog…

    Fantastic! So glad you read and commented.
  16. SafetyNurse1968

    Case Study (CSI): I’m too tired to walk the dog…

    Oh that’s even better! Thank you so much!
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