P-RN

A coworker in the ICU was checking whether an elderly patient was oriented and asked her if she knew where she was. The woman looked at her like she was stupid and replied, "Of course I know where I am, I'm right here! When we finished laughing we agreed that she certainly was correct, though perhaps not really oriented.

Most Americans have strong feelings about gun control, whether in favor of more or less. Legislation has even been passed restricting physicians from discussing guns with patients. What is your opinion about healthcare professionals discussing safekeeping of guns in the home? Gun ownership and regulation is a very emotional issue in the U.S. and there has been strong reaction to whether physicians and other healthcare providers should be involved in doing more to curb gun related injuries and deaths. I would like to hear some of your opinions regarding physician involvement, but first let's look at some of the gun statistics in the U.S. More than 108,000 people are shot per year in murders, assaults, suicides, suicide attempts, unintentional shootings or by police intervention. * More than 32,000 of them die. * The U.S. has the most gun homicides of any developed nation. 29.7 per 100,000. * Everyday 297 people are shot. * 89 people die. * 31 of them are murdered. * 55 are suicides. * 2 are killed unintentionally. * 1 is killed by police. * 1 is unknown intent. * One in five deaths are people ages 15-29. Over 17,000 American children and teens are injured or killed each year due to gun violence. * 2,677 of those children die. * Nearly 48 youth are shot per day including 7 fatalities. * 5 are murdered and 2 are suicides. 1 in 3 homes with children have guns. * 42% of parents with guns keep at least one unlocked. * 25% of parents with guns keep at least loaded. * 3 in 4 children know where firearms are kept in the home. (Statistics; bradycampaign.org). It has been suggested that clinicians could play a major role in reducing children's access to guns by asking if there is a gun in the home, and if so, counseling on firearm storage practices. One study showed that patients who received counseling on firearm storage were more likely to make a change in storage practice than patients who did not receive counseling. (64% vs 33%). (J Am Board Fam.Pract). Pediatrician's offices and hospitals routinely give out infant and car seats, would it also be appropriate to distribute trigger locks and lockboxes? Firearm related injuries are a public health issue, so should there be public health initiatives regarding firearms such as there have been for reducing tobacco, toy and motor vehicle related deaths?

It all began with a nurse in the open heart recovery at the hospital where I worked. She thought that a new resident was dreamy and wanted me to introduce her to him. When she said that she would love to get him in front of her fireplace with a bottle of wine, I jokingly replied that I would be willing to come over and after two bottles of wine I would begin to look as good as the resident. I got some laughs from the other nurses and thought no more about it. Then about two weeks later I entered the patient elevators with two of the nurses who had been present when I made my joke. One of them grabbed my tie and yanked it, tightening it uncomfortably, forcing me to remove it so that I could retie it. As I removed the tie, the nurse who had yanked it said, " We don't need any wine, you look just fine," and then both nurses grabbed my shirt, popping buttons and pulling it open exposing my chest and belly. As luck would have it, the elevator doors opened at that moment and a group of seven or eight visitors looked in to see us in what looked like a very compromising position. The two nurses promptly dropped their hands from either side of my shirt and looked very guilty indeed. The visitors were so surprised that none of them entered the elevator, but stood and stared as the doors closed. I'm sure they heard us laughing hysterically after the doors closed, and I have always imagined these people going home to tell friends and family that all the sex on those medical shows is for real. I didn't really find heaven on the seventh floor, but it sure appeared that way. On another day I was joined in the cafeteria by a student nurse who was not eating and when I asked her why she wasn't she proceeded to tell me that she had given her first bed bath that day and no longer had any appetite. She explained that when she got to the end of the bath and was cleaning the elderly gentleman's rear end she managed to get a piece of stool on her finger. She was quite grossed out and couldn't wait to remove her gloves when suddenly she sneezed and unfortunately as an automatic reaction put her hand to her nose. Of course some of the stool went into her nostrils and she could not get rid of the smell. I tried hard to be sympathetic, but it was impossible not to laugh at her experience. Another event that always amused me was when a nurse I was working with was checking an elderly woman's orientation to place and time and asked her if she knew where she was. The 92 year old woman looked at her nurse like she must be an idiot and replied, "Of course I know where I am. I'm right here". We couldn't fault her reasoning, but it was very hard not to burst out laughing in front of the woman. These are but a few of many amusing events that have added a little levity to my otherwise often stressful job and now I'm requesting that some of you out there bare your souls, (or chests) and tell us about some of your amusing and/or embarassing moments at work.

Well said Raicho. Whether you agree with the law, or think it is garbage, as Kyrshamarks does, the article is based on the facts, not opinion and anyone wishing to point out errors is welcome to. Name calling is not particularly productive, or mature.

A frequent topic of nursing discussions and articles has been that of nurses eating their young. This refers to the instances when older, more experienced nurses withhold the support newer nurses need when starting out in their careers. Rather than using their expertise to guide and aid new, inexperienced nurses, many older nurses seem to have the attitude that as they once had to struggle and learn to cope with the challenges of nursing without anyone's assistance, so should the new nurses have to go it alone. It has been a chronic problem that has driven new nurses to leave nursing areas they had aspired to work in, and oftentimes caused new nurses to leave the nursing field entirely. No one knows how many talented people have been driven from the field of nursing, but it seems to be a widespread problem if all the articles and discussion in nursing forums is representative of most nursing environments. For the nursing profession, with nationwide shortages, it is most unfortunate, and for new nurses who have spent years in school only to get discouraged and leave nursing early on, it is tragic. Nursing is losing many extremely talented people each year who might otherwise have had long, productive nursing careers. Another important area nurses sometimes neglect is that of nursing recruitment. I refer not to hiring nurses, but of encouraging people to go into the nursing profession. All too often we complain of our difficult and stressful work, long hours and the many challenges we face, but neglect to talk about the rewarding aspects of our work, the reasons we entered the nursing profession and stay in it. It is human nature to complain, and it often helps to recover from a stressful shift by venting, but we are sometimes woefully unaware of the harm we do by discouraging interested people from considering nursing as a possible career choice. A person who might have grown up aspiring to become a nurse could all too easily reconsider if the nurses they encounter always grumble about the stress, patient workloads and long hours, never mentioning the satisfaction derived from caring for the sick, helping bring babies into the world, or assisting the terminally ill to make their transition in comfort and support. We sometimes forget in the daily struggle just how much good nurses accomplish. There are many good reasons why nurses are one of the most trusted professions in survey after survey. Whenever an interested person asks about my work, and this happens most often when I am on the job, I talk about the many rewarding aspects of nursing, and I like to stress that one of the great things about nursing is the tremendous diversity in nursing roles. There are so many areas of expertise in nursing and if a new graduate is unhappy in one area, they have so many choices available to try until they find a perfect fit. A nurse has so many options: caring for the elderly, for babies and children, working in the OR, ER, home care, teaching and and so on. There is something to satisfy the interest and aspirations of most anyone. A year ago I met Maria at the dog park where most afternoons we take our dogs to play. Maria's daughter was in nursing school and I came to know Lisa through her mother who frequently mentioned that Lisa was doing well in school and would graduate soon. Lisa graduated with honors from a local university and looked for a job as a graduate nurse, but was not successful in finding a position that was a good fit for her. Lisa was primarily interested in pediatrics but most places weren't hiring or were only hiring experienced pediatric nurses. Lisa and I spent afternoons at the park talking about our careers as we watched our dogs play. Lisa seemed to be the kind of person the hospital where I am emloyed looks for; she is kind, thoughtful, empathetic and humbly intelligent. I started making phone calls to help her get her foot in the door, and our park conversations became "mock interviews". She was able to answer the "tough questions", and was very soon ready for her interview. Lisa interviewed and was hired and is in the midst of her orientation process. We continue to talk at the dog park or the hospital cafeteria if she has a question or just needs to talk. I'm excited to watch as she grows to be a valued member of the pediatric nursing team. Sue and I would meet Friday nights to watch our husbands play softball. The topic of conversation in the bleachers often focused on Sue's dissatisfaction with her career. She had a good job with a pension and excellent benefits, but wasn't getting the job satisfaction she needed to be truly happy. Sue would often refer to the time when she worked as a medical assistant in a physician's office. She seemed to remember every patient and still kept in touch with the staff even though it had been several years since she had worked in the office. She had even kept her medical assistant licensure active after all these years. I suggested she apply at the hospital unit where I worked as we were looking for a Patient Care Assistant. It would mean a huge pay cut, but the hospital would pay her tuition to go back to nursing school which seemed to be her calling. After a bit of soul searching Sue decided to take the plunge. She was hired as a PCA, went to school and graduated. Sue has been working as an RN for five years now and has never regretted the change of careers. She still sends me cards on occasion to thank me for encouraging her to make the career change. On numerous occasions I have had someone approach me to say that they had met me a number of years earlier when they were either a patient or visiting a patient and had chosen a nursing career based on questions they had asked me about my career and how I liked it. I don't always remember the person or the earlier encounter as usually a few years have passed, but it has been extremely gratifying to learn that I have had a positive impact on someone's life and on the nursing profession in general. Nursing is a profession with so many different fields that there is an area to satisfy nearly everyone. One person may not enjoy working in one specific area, such as pediatrics for example, while another person may find that to be their favorite area. Another person may prefer intensive care or even a management position. There truly is such a wide range of areas in which to work, and it is difficult to predict where a person might excel and be most gratified. We have the ability and responsibility to encourage people to enter the nursing profession which will effect not only their future, but those of the people they will care for in their nursing careers. Those same people we have recruited to become nurses may go on to encourage others to enter the profession thus promoting future generations of nurses. We need to always be looking for that passion in people we meet because one never knows who might have all the great qualities we look for in a nurse. It is an awesome responsibility, but also a wonderful opportunity to help ensure the future of nursing.