Brooke Schmidt

Definitely, there is so much room for healthcare professionals to contribute quality information outside of their traditional jobs.

That’s a great exercise. We had something similar in school as well.

Courageous is such a good word to describe nurses. Thank you for sharing!

Thank you for reading! And that’s an excellent point about using those questions for simple decisions as well.

When the Tube Gets Stuck When my sister-in-law video-called me on a Wednesday night because my niece decided to shove her finger into a tube, I answered. Being one of the only medically trained members of the family, I get a lot of these calls. After some ice, spray Pam, and a lot of tears, the tube was no longer attached to my niece. I often wonder what the Google search would look like if my family and friends didn’t have me to call. I wonder if they know I sometimes Google these things too. Is it what I learned in school, what I have learned in 10 years on the job, or just common sense? The simplicity of these phone calls is devoid of the Media's influence, a clear-cut problem and solution. What has caused healthcare decision-making to become so complicated? In the era of social media and the internet, there is a constant barrage of information. Add in a pandemic and constantly emerging infectious diseases it is easy to lose trust in your common sense. Who do you trust? Do you find yourself mindlessly doom scrolling, searching for an answer you already know? The Media's Influence Unfortunately, over the past few years, healthcare decisions and information have been politicized. People on both sides of the political spectrum have drawn conclusions and made healthcare decisions based on specific media outlet opinions. Epidemiologists, infectious diseases experts, and doctors have taken to social media to share their information and guidance. They have amassed followers looking for credible information devoid of political opinions. Unfortunately, medical experts who have decided to share their lives, information, and opinions have also faced bullying and harassment. It has even led some to shut down their social media profiles over the fears of personal attacks and attacks on their children. So unless you have time to spend watching the news, pouring over the internet, or scrolling through social media, it can be difficult to know where to turn in terms of information that helps inform your health care decisions. People often perform a Google search with a specific question; they click on the top link and find the answer they are looking for. But how often do people take the information out of context or not take the time to validate the source of the information? Have you ever read an article after a quick Google search and checked the author’s credentials? More often than not, the author has no medical or healthcare-related background. They may interview doctors or cite credible sources, but they are still using their non-medical background to synthesize data and information. They run with the answer they found, often sharing it with others and abandoning their common sense. Before the internet and social media, people relied heavily on their common sense or that of their friends, family, and neighbors. Misinformation was still spread but not at the global break-neck speed it is today. People often trust “doctor Google” over their physician. The way we make healthcare-related decisions has vastly shifted since the introduction of the internet. You can find answers to most of your common ailments in a quick search online. The caveat to this newer trend is those non-medical individuals are making decisions that can contribute to delayed diagnoses and treatments. How I Make Decisions I have never been more grateful for my required research class in nursing school. It was drilled into us as nurses to look for credible sources, how to read and understand research studies and journals and synthesize important information. As a nurse, a mom, and a family member to high-risk individuals I pour over the information, facts, opinions, and advice. Through endless hours of research and anxiety, I have come to find a few credible sources I trust to help me make health care decisions. I now use a mixture of local public health data (wastewater, hospitalizations, and positivity rates of infectious diseases), epidemiologists, infectious disease specialists, and our pediatrician for decisions related to our kids. Navigating health decisions is multi-layer for our family as we have different risk layers depending on if it is my husband and me, our kids, or our extended family that includes high-risk individuals. Every decision is made based on the risk vs. benefit to the people involved. I also take into account the risk of transmission to others and how our healthcare-related decisions impact others. When I reflect on my common sense regarding healthcare decisions, I fear I have wasted hours, days, and even weeks of my life filling my brain with information that ultimately did not change the decisions I made. The influx of opinions and facts made me second guess what I already knew in my gut. It made me throw my common sense from years of training and experience out the window and join the media hysterics. At the end of the day, healthcare decisions boil down to a less complex decision hierarchy - Am I making this decision based on factual data or others' opinions? Am I making this decision because it is best practice or because it is more convenient and fits the status quo? Is the answer truly as simple as just figuring out how to remove the tube from a four-year-old finger?

Yes, it was very scary and unknown in the early days. I am so glad we all have access to PPE now!

So well said! Thank you for sharing.

I remember the early days of the pandemic- signing up for my free crocs and free slippers, showing my badge at the chick-fil-a drive-thru for free lunch. My neighbors rang bells and cheered at night. For a few short minutes, I thought I felt like a hero. But the reality quickly set in that I was pregnant, I was working on the front lines, and I was fighting for the very thing people are now celebrating the end of- wearing a mask. During the first few weeks of the lockdown, we were told we could only wear a mask for Covid positive patients or those with known exposures and symptoms. As a community care nurse, I was walking the halls of nursing homes and assisted living facilities and going into patients' homes with no protection. Once we were allowed to wear masks, they needed to last the whole day, the same paper-thin masks we were told to dispose of after each patient in the past. They needed us to collect our used masks to be cleaned so that we didn't run out. They ultimately asked that we stop wearing makeup because it prevented the masks from being re-used. I did not feel like a Hero. People were scared; I was scared. The facilities I worked with were receiving little to no guidance. They didn't have access to masks and supplies, and even if they did, they didn't have the money to afford them. I had caregivers calling saying they couldn't find toilet paper or soap to provide basic services to their clients. They would ask me if I had masks or gloves to spare, but I didn't. I would sit in my care and cry that I was having to choose my safety and my unborn child's safety over giving the mask off my face to another person in need. A memory care I visited required the nurses to stand outside and spray their bodies with Lysol before entering. I mentally started calculating if the risk to the frail elderly inside from my visit was greater than me covering my pregnant body in chemicals. I did not feel like a hero. I struggle to find the words to describe what it was like walking into a nursing home with biohazard signs and caution tape on the door. Visibly pregnant hoping my mask was enough to protect me as I pushed through the plastic. Seeing fear on the faces of the staff as they went room to room helping me swab noses. All of us hoping the results came back negative. I did not feel like a hero. I'm not sure ultimately what was worse, the fear of COVID or the sheer pain of the isolation placed on our elders. They were separated from their families and shut behind doors. I was often the only conversation or connection to the outside world they would experience that day. As time went on and people had "pandemic fatigue,” they had the choice to resume activities and socialize with friends. As they stared at me in the grocery store still masked, as my family shook their heads when I declined their invitation to a party, as my kids stayed inside, I did not feel like a hero. I carry the torch for the ones I cared for that still don't have a choice. I carry the torch for the pregnant healthcare workers, people who are immunocompromised. I carry the torch because I cannot forget the fear I felt and the fear I saw in others. As I look back and reflect on the pain, loneliness, and isolation over the past years. I shed tears over the hands I held at the end; their last words, thoughts, and breaths were witnessed by me and not by their families. I am grateful I was there when others were not able to be. I am grateful for the child I brought into the world amid the chaos. I am grateful for the choices I made to protect those around me when the rest of the world moved on. But as the Hero signs have come down, the free lunches are long forgotten ... I do not feel like a Hero ... I don't think I ever did.

I work for a home health agency, we do shift work which sounds like what you're interested in. I work full time with one patient (3, 12 hour shifts). Many nurses work with more than one patient or agency depending on the hours and experience you want. I only drive to and from my patients home. These cases are usually medically complex children or adults with trachs/vents/central lines/g-j tubes and they will qualify for a certain number of hours per day/night.

I work 12 hour shifts, 3 days in a row, it is awful sometimes, but having 4 days off every week USUALLY makes up for it.

I work in home health, our standard is to use a biopatch on all PICC/central line sites. The supplier we get our kits from sends the biopatch separate as the pre made kit does not contain the patch.

I work in WA state and my agency requires us to call into a system, we are given a code for each shift.

1. Seattle, WA 2. $22.30/hour +$1.00 for nights and weekends 3.Offers full benefits, but they are pretty expensive 4. PTO, time and a half for holidays