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jeastridge BSN, RN

Faith Community Nurse (FCN)

BSN, RN, Faith Community Nurse

Member Member Writer Expert Nurse
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jeastridge is a BSN, RN and specializes in Faith Community Nurse (FCN).

Joy has worked in a variety of fields in the nursing profession over her 35+ years of nursing, including GI/GU, Medical Surgical, Pediatrics, Home Health and Hospice. While being a FCN for 22 years, she also worked in hospice and obtained her CHPN. In addition to writing for the website, she pursues other avenues of writing and has published a children's book and two Bible studies. She is active in her community, in her church and with her ever-growing family. She enjoys long walks in the mountains of East Tennessee, cooking for crowds and reading for pleasure. 

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jeastridge's Latest Activity

  1. jeastridge

    Nurses and Bullying: 4 Things You Can Do

    Thank you for your response and glad you stayed with it! Joy
  2. jeastridge

    Code Green and Emotional Trauma: How Nurses Help

    Thank you for your honesty. You make excellent point. The staff should always call a code green whenever there is a threat. I'm sorry it feels like the article implies otherwise. That was not my intent. Joy
  3. jeastridge

    Code Green and Emotional Trauma: How Nurses Help

    Thank you for your helpful comment. You highlight the importance of preparedness, knowledge and rapid response. Joy
  4. jeastridge

    Code Green and Emotional Trauma: How Nurses Help

    So well said. Thank you for your thoughtful comment and for sharing your perspective. You make some important points. Joy
  5. “Code Green 5th floor. Code Green 5th floor.” The hospital operator’s voice made my pulse skip a beat even though I was far from the announced location. Code Greens [in this case meaning a combative person who may be armed] have become more common as we face more crowds, more recreational drug users, and more angry, frustrated people in our facilities. As nurses, we are sometimes part of situations that lead to the dreaded “Code Green” announcement as we call out for the necessary help. We undergo training in how to respond and follow the required steps, but we do begin to wonder if the number of these types of crises is increasing, and if so, why? The Team Approach Some hospitals have successfully formed specialized teams to address Code Green situations and to help de-escalate highly charged encounters. At Pinnacle Health System in Harrisburg, Pennsylvania, their Code Green Response Team, started in 2013, has saved personnel and patient injury, money and time away from work. Their example may be trendsetting as other systems look to find ways to decrease violence inside our hospitals. Code green prevents workplace violence Trauma-Informed Care Another opportunity for learning and forward-thinking is the Trauma Informed Care Project .The training invites participants to acknowledge that past trauma affects daily behaviors. Children are especially vulnerable to the effects of trauma and many childhood experiences accumulate to produce adverse effects leading to the term ACES (Adverse Childhood Experiences). The website goes on to explain that the goal of this foundation and this project is “organizational structure and treatment framework that involves understanding, recognizing, and responding to the effects of all types of trauma. It emphasizes physical, psychological and emotional safety for both consumers and providers, and helps survivors rebuild a sense of control and empowerment.” During the training, participants are invited to re-think “acting out” and instead of asking “What’s wrong with that child?” Ask instead, “What happened to that child?” These subtle but significant shifts in thinking can help us move from finger-pointing and judging to more constructive patterns of interaction where healing can actually take place. Emotional trauma carries over, of course, into our adult years. If unacknowledged, untreated, unresolved, it can surface unexpectedly and often explosively, leading to our current question regarding Code Green. Victims of traumatic incidents can sometimes repress or “forget” the memories of what happened to them only to have those come back during challenging or stressful times —such as times in the hospital with a loved one or being sick and in pain themselves. The post-traumatic stress of past troubles can lead to excessive anxiety, anger, and unstable emotions. The Body Keeps the Score In his book, The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma, Bessel Van Der Kolk, MD, asserts that past trauma manifests itself in actual physical disease. If unresolved, trauma will eventually lead to physical illness in a variety of diagnoses. “Even though the mind may learn to ignore the messages from the emotional brain, the alarm signals don’t stop. The emotional brain keeps working, and stress hormones keep sending signals to the muscles to tense for action or immobilize in collapse. The physical effects on the organs go on unabated until they demand notice when they are expressed as illness. Medications, drugs, and alcohol can also temporarily dull or obliterate unbearable sensations and feelings. But the body continues to keep the score.”(p46) Responding Appropriately As nurses, we are occasionally faced with responding appropriately to challenging situations: talking an agitated patient down, listening well, knowing when to get help. How can we prepare ourselves to be even better equipped to face difficult encounters? Be in the Know Take mental health classes that are offered for CME; the Mental Health First Aid class is valuable as are the Trauma-Informed Healing sessions. Learning about mental illness, PTSD, and other psychiatric illnesses gives us a good preparatory knowledge base. Responding Empathetically When Possible This can help resolve some low-risk situations. Many people long to be heard, really heard. They may even realize that we cannot resolve their situation, but they don’t want to be brushed off. They want to know someone cares. For some, that may be the beginning of healing and just what is needed to get them through a rough patch. Call for Help as Needed There is simply no substitute for getting help when a crisis arises. Maybe your facility, like Pinnacle Health, can consider starting a Code Green Team which specializes in defusing and de-escalating crisis situations. Sadly, Code Greens are more common than we would like for them to be. There are a lot of hurting people out there: both our patients and those that are surrounding them in their time of illness. We have no way of knowing what trauma might have happened to our patients or their families and loved ones previously. But we do know that they carry those hurts with them when they come in for treatment. As nurses, we are often presented with really messy scenarios. Being professionals, we do our best to make the best of even the worst of times. What helps you to respond appropriately to tense situations?
  6. jeastridge

    Nurses and Bullying: 4 Things You Can Do

    You bring up some good points. Thank you for sharing your perspective. Joy
  7. jeastridge

    Nurses and Bullying: 4 Things You Can Do

    What great suggestions! I especially like the idea of having cash on hand. Money can't do a lot of things but it CAN buy options. It can make life more bearable by providing that escape valve--just in case it is needed. Thank you for sharing your constructive ideas. Joy
  8. jeastridge

    Nurses and Bullying: 4 Things You Can Do

    Great story. Thank you for sharing. I was reading Richard Rohr's book, THE NAKED NOW, this morning and he says, "What you see is what you get. What you seek is also what you get. We mend and renew the world by strengthening inside ourselves what we seek outside ourselves, and not by demanding it of others or trying to force it on others." (p.160). You showed respect and behaved with decorum and integrity.
  9. jeastridge

    Nurses and Bullying: 4 Things You Can Do

    You bring up an important point: our personal lives can "bleed over" into our professional lives so easily. We also can have a tendency to promote co-dependency and tolerance of bad behavior based on excuses. While we all want to be sympathetic to the troubles our managers and co-workers are experiencing, we also want to keep our patients front and center--while at work, they are our #1 concern and responsibility. Thank you for your comment. Joy
  10. jeastridge

    Nurses and Bullying: 4 Things You Can Do

    You are right. There is a lot of truth to the need to find a way to stand up to bullies and to be firm. But it is easier for some people than for others, and in some cases, bullies make it impossible for victims to have a voice. I have no doubt that you are the kind of person that speaks up for others, as well. Thank you for your comment. Joy
  11. jeastridge

    Nurses and Bullying: 4 Things You Can Do

    Well said and so true. Thank you for your insightful comment. Joy
  12. jeastridge

    Nurses and Bullying: 4 Things You Can Do

    Agreed. Good dynamics on the floor and among staff members often starts right at the top. Joy
  13. Cindy was an older new grad. She went back to school after a long and successful career as a chemist, deciding that she wanted to be a nurse and explore other avenues of service for her “second half” of life. Capable and efficient in her first line of work, it was a shock to find herself as a novice where everything felt unfamiliar and where mastery was a ways off. Her first place of work was on a busy ortho floor. The second week at work, she called me crying. “Their expectations are so high. They keep threatening me.” I tried to listen without judging or offering advice, but something just seemed off. Every few days she texted or called and what she described didn’t seem like anything I had ever experienced as a nurse: where there should have been mentoring, there was censoring; where there should have been guidance, there was abandonment; where there should have been counseling, there was silence and isolation. The source of most of the problems was her preceptor, a young nurse, who my friend described and very physically attractive but unkind. As it turns out, she was a bully. Nursing is Not Immune to Bullying While we would hope that in such a caring profession, we would find a greater percentage of people with compassionate care agendas, sadly there are also a number of practitioners who exhibit the characteristics of a bully: they are critical, negative, they isolate their victims, avoid meeting with them, and generally make life miserable. According to a study by Etienne, “Bullying in the nursing workplace has been identified as a factor that affects patient outcomes and increases occupational stress and staff turnover.” (Exploring Workplace Bullying in Nursing) Signs of Bullying The trouble with bullying is that it is often subtle and therefore difficult to recognize as such. While the playground bully may be overt and even violent, the adult bully is usually disguised under heavy layers of professional accomplishment and years of experience with manipulating others. They come in all shapes and sizes, both men and women, old and young. The “mean girls/guys” from 7th grade grow up, don’t they? But sadly, they sometimes don’t leave behind their old ways of treating others, and they bring those tactics with them when they put on their scrubs and head to the nursing workplace. One of the primary manifestations of bullying is that the victim often feels that it is all his/her fault. After exposure to the bully’s tactics, they may even think to themselves, “If only I did this or that better, then they would not treat me this way.” The thought processes at the center of the bully/victim relationships can sometimes be lifted straight from our textbooks about abuse. Just as victims of domestic abuse many times blame themselves, nurses who are victims of bullying find themselves looking inward and wondering if there is something wrong with them. What are some of the classic signs of a bully boss or co-worker? 20 Subtle Signs of Bullying at Work More Subtle Signs Deceitful and manipulative- making promises but not keeping them or using promises to purposely disappoint. Shaming and blaming- bullies want the victim to blame themselves. Ignoring or undermining work- purposely “forgetting” to notify someone of meetings, belittling their work or accomplishments. Intimidating and criticizing- setting impossible standards and even threatening. Diversion and mood swings- bullies might avoid the victim so that the work issues cannot be resolved in a timely manner; and they are subject to widely varying moods (which boss/co-worker will be coming to work today? The sweet one or the nasty one?) Overt Bullying Aggression and intrusion- actual physical altercations with the bully entering your personal space. Belittling, embarrassing and offensive communication- using their position to cause you harm, either physical, psychological or professional. Coercion and threatening- pushing the victim to do things they don’t feel comfortable doing and using threats of termination or other punishment to get compliance with their demands. So, if you or someone you know is being bullied in the workplace, what can you do? Document- Keep a record of any threatening or inappropriate emails, texts or interactions. Should it become necessary to report the bad behavior, it will be important to have specific occurrences, words used, and frequency of episodes. Also, learn your workplace policies on bullying and what your recourses are. Detach- Try to look at the occurrences in light of how this person treats others. Have you been “picked out” for special scrutiny? Bullies are sometimes bullies across the board but at times they pick out a few victims, zero in on those and treat others as allies, making the other staff members into (sometimes) unwitting accomplices for their own bad behavior. Dare to Defy- Standing up to a bully is hard and practically can be impossible. Often, persistent bullying requires cutting our losses and moving on to another position. But adult and boss bullies—like those on the playground—can respond to pushback: maintaining eye contact, standing firm, ignoring or not acceding to their demands. This is harder to do than it sounds, because the victim of a bully at work frequently is not in a position to resist and finds themselves being jerked around by the perpetrator’s continually changing and escalating demands, whims and moods. Defend- Be on the lookout for bullying behavior around you and if you see something, say something. As for Cindy, in the end, she resigned after 3 months and went in search of another job—certainly not the route a new nurse wants to have on her resume—but a physical and psychological necessity given the bullying she experienced. After the rocky start, she went on to have an extremely successful career as a nurse and to find the profession a satisfying fit for her talents. Have you witnessed bullying in your workplace? How have you been a victim of bullying?
  14. jeastridge

    12-Hour Shift | Life of a Nurse

    Great article! Thanks for sharing. You are a credit to the profession! Joy
  15. jeastridge

    Breast Cancer Simplified

    Thank you for your comment and for sharing your experience. You have some important views for others to consider. I wish you all the best moving forward. Joy
  16. jeastridge

    Breast Cancer Simplified

    My phone lit up with a message from a friend in a nearby town. “Let’s get together for lunch this week.” I responded with, “Sure, what’s up?” Her answer made me sit down. “Breast cancer.” Breast Cancer Statistics The “C” word is met with foreboding by us all, but breast cancer brings along with it a special dread to women: possible breast-altering surgery, treatment that can include chemo and radiation and the increasingly less likely risk of death. With statistics showing that according to the National Cancer Institute (NCI), “12.8% of women born in the United States today will develop breast cancer at some time during their lives,” and “2.6% of women in America will die of breast cancer.1 As scary as that statistic is, the NCI emphasizes that the same numbers also show that there is a 7 out of 8 chance that an individual woman will NOT have breast cancer in her lifetime. All the statistics invite us to careful monitoring, including regular mammograms after age 40 or 50 for women with average risk. Additionally, many physicians recommend genetic testing such as for BRCA gene if there is a higher than average family history of breast cancer or any ovarian cancer. How to Reduce Your Risk All women have the opportunity to adhere to healthy lifestyle choices that can help decrease their chances of getting breast cancer including2: Limit alcohol. Greater alcohol intake=greater risk. Don’t smoke. Weight control. Physical activity. Breastfeed. Limit duration and dose of hormone therapy. Avoid radiation and environmental pollution. Treatment Options As professional nurses, we often get asked questions about breast cancer and treatment options. Unless we are actively working in the field, we are not usually qualified to answer questions and often must refer to others or to reliable published material. However, it is important for us to stay up-to-date and understand some of the more recent changes in breast cancer treatment. Staging According to LaCosta Brown, RN, MSN, OCN, a nurse navigator for breast cancer, a lot has changed in staging breast cancer since January 2018. Previously, staging involved one sheet of paper, one chart essentially, and noted tumor size (T), nodal status (N), and metastasis (M). The TNM staging method had been around for a number of years and served as the guide to defining surgery and treatment options. However, for the past 2 years, grade and biomarkers are also taken into consideration. The total picture is the TMN + G + B. Grade Grade refers to how abnormal the cancer cells are when examined under a microscope and range from G1 - Well-differentiated (low grade) to G3 - Poorly differentiated (high grade). Essentially, the higher the grade the faster the spread of the disease. Biomarkers - HER2neu Biomarkers include estrogen receptors, progesterone receptors and HER2neu (Human epidermal growth factor) status. 80% of tumors are hormone-positive and thus respond to treatments that help to curb their growth, treatments that include drugs like Tamoxifen and Arimidex. So if cancer responds to hormones, it is Estrogen or progesterone positive and therefore would respond to these drugs that specifically work to slow down and impede tumor growth and spread. These long term “chemo pills” are generally used for 5 years. This anti-hormonal therapy can prevent breast cancer re-occurrence. HER2 is a protein that when present can cause cell growth and survival. Being HER2 positive opens up the possibility of treatment with Herceptin or Perjeta. HER2 presence is considered, according to Brown, as a “foot on the gas. It is go-go. The treatment modalities of Herceptin and Perjeta put on the brakes and slow or stop the growth of the tumor cells.” According to the CDC, if cancer is the “house” the 3 markers are “keys” that can help treatment get inside and destroy or slow down the cancer cell. If the “house” doesn’t have any one of the 3 keys, it is called “triple-negative.”Triple-negative breast cancers, or those that don’t respond to anti-hormonal treatment, make up less than 20% of all breast cancers. Along with surgery, the treatments include chemotherapy.3 Immunotherapy for breast cancer is also a growing field and one where promising research is being done. The new methods of precision evaluation breast cancer include genetic profiling of the tumor specimen and are much more specific and helpful in terms of specifying treatment options and helping patients decide how to proceed. New Treatment Options In years past, radical mastectomies were the treatment of choice for most breast cancers. As medical knowledge and treatment options have developed in recent years, more women are able to get simple lumpectomies and follow that up with the appropriate treatment given their staging. They may be able to have sentinel node identified at the surgery for biopsy instead of removing all the axillary nodes, reducing the problem of lymphedema of the arm after surgery. My friend and I met for lunch and talked at length about her plans for surgery and follow up treatment. Along with the technical and medical conversation, we reconnected with each other’s lives, offering one another emotional and spiritual support, realizing that as important as all of the staging and drugs and treatment info is, so also is the support we offer one another when going through diagnosis and treatment. References American Cancer Society- https://www.cancer.org/cancer/breast-cancer/about/how-common-is-breast-cancer.html Mayo Clinic - Breast Cancer Prevention: How to Reduce Your Risk - https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/breast-cancer-prevention/art-20044676 Centers for Disease Control and Prevention: Triple-Negative Breast Cancer https://www.cdc.gov/cancer/breast/triple-negative.htm
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