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  1. The doors to the ICU swung open as I swiped my badge and I took a deep breath before stepping forward to face Jane and her family. An elderly woman, 90+, Jane faced day 7 on a vent in the ICU after a serious bout with pneumonia. I greeted her son who sat quietly at her bedside, by now impervious to the low key but constant whirr and beep of the machinery that worked to keep his mom alive. After greeting him, I stepped over to take Jane’s flaccid and swollen hand in mine and greeted her, too. Talking with the son, he related the events of the past 24 hours. He emphasized that the doctors assured him she was “stable” and “not suffering.” Despite her advance directive that stated her preferred wishes not to be intubated, when the time came, she was lucid and changed her mind, giving hurried permission for interventional care. After talking a while, I brought up the idea of talking with the doctor about having a Palliative Care Consult. Emphasizing that this was something the doctor would have to order if she thought it was appropriate, I described the possible perspective they might bring to the overall picture. During our conversation, his internist came in and said, “I have put in for a Palliative Care Consult” clearly seeing the same picture that we were and thinking it might be time to pause and consider how to move forward. After prayer and a moment with scripture, I went on to see others in the hospital before heading over to the church where I have an office. Seeing patients in the ICU is not an everyday occurrence but does happen with a fair degree of regularity. In that environment, the Parish Nurse can serve as a spiritual support person, an interpreter for medical terminology and procedures and a liaison between the family and the staff, especially if difficulties arise. At the church, I briefly checked email and made a note to call Mr. S back about his grief. Having lost his wife of 57 years just a few short months ago, Mr. S told me he felt adrift; one of the things a Parish Nurse can do is help cast out lines of communication and connection, helping him find new ways to anchor himself —social activities, service opportunities, and spiritual comfort. I prepared a devotional thought before going to a Caregiver’s Support Group and sharing an hour with them. Meeting once a month, the group of a dozen or so people helps one another through the thick and thin of caregiving, discussing different topics each month and sometimes even having special speakers from nearby facilities. After a quick lunch at my desk, I joined a weekly meeting with the pastors on congregational care, discussing how we could best address the needs of our members who were going through a variety of crisis. We usually assigned one designated person to be in charge of responding to a particular need, then bring the others in as was necessary. After the meeting, I spent the afternoon returning phone calls, checking on people who were post-op, making notes after each phone call or contact, and working on coordinating some of our outreach ministries: prayer shawls, frozen casseroles, cards, and birthday visits to our “At Home” members. One of the beautiful things about Parish Nursing is that there is not a “typical” day. Every day is different and some more challenging than others. What I have described above could stand as a representative sample of what happens many days. As members of the church staff, Parish Nurses work closely with pastors, collaborating in the wholistic care of their parishioners: body, mind and spirit. Parish Nursing, begun in the 1980s by Grainger Westburg, is a place where nurses can find new ways to use their skills. While my position is a regular part-time position and I receive a small stipend for my work, many Faith Community Nurses are volunteers who work just a few hours a week, checking blood pressures on Sundays and answering questions or making phone calls. There are a number of definitions of Parish Nursing, but they all include most of the following, “A Parish Nurse is a registered nurse with specialized knowledge who is called to ministry and affirmed by a faith community to promote health, healing and wholeness. The role of the parish nurse is to promote the integration of faith and health in a variety of ways that reflect the context of the faith community. Specific examples include: health advocacy, health counseling, health education and resource referral (http://www.capnm.ca/fact_sheet.htm )” If you are interested in being a Parish Nurse, how do you get started? First and foremost you will need to have the support of your church’s leadership to work in this capacity. Talk with your congregation’s governing body and gauge their support. If you feel led to continue after that, you can take an online course in becoming a Parish Nurse to better prepare yourself. You can also seek out other Parish Nurses in your area. Nationally, the Westburg Institute serves as the unifying organization for FCNs, holding an annual symposium, publishing articles and books and providing visionary leadership. After a busy afternoon, I snapped my computer closed, double checked my calendar for the next day and got ready to meet a girlfriend for a walk in the spring sunshine, feeling blessed to be able to be a nurse in a church.
  2. jeastridge

    Yes Ma'am, I mean Yes sir

    Cool bio. Just sayin.
  3. jeastridge

    Nurse on a Mission Trip to Belize

    I left for Belize on a Saturday after running around getting ready to be gone for a week, I almost plopped into my airplane seat, grateful for a few minutes of respite when I began to wonder, “What have I gotten myself in to?” Going was my daughter-in-law’s idea. As a PA, she had been wanting to go serve as part of a medical mission. My husband, a family doctor, and I readily agreed to join a team that gradually grew to 28 to serve for a week in the inland part of the Central American country of Belize. Long a part of the British Commonwealth, the country has English as its official language but with a total population of under 350,000 it remains needy with many parts of it underserved medically. Our team went to work in a compound that housed a medical and dental clinic where foreign doctors came 4-5 times a year. We were there to volunteer doing everything from family medicine and dentistry to screenings, hearing assessments with fitting for solar powered hearing aids and giving out of basic “reader” eyeglasses. The first day we went to church in the morning and then saw 50 people that afternoon. Overwhelmed by the numbers of people and the long lines, we immediately began to work to prioritize, triage and figure out how many people we could realistically serve a day so that we would not end up having people wait all day only to be turned away. We did our very best to work with compassion and efficiency but there were still people we could not get to. As a nurse and a sort of coordinator for the team, it was my job to help match volunteers with jobs they were suited for and to watch over the general work of the clinic, intervening where there might be problems. Together with other nurse volunteers, including a local nurse who helped with translations when people were not fluent in English (Belizians speak a mix of English, Spanish, Creole, and some Mayan languages), we checked vitals, weights, blood sugars, occasional hematocrits and lots of urine samples for infection and pregnancy. Our team had access to on-site X-rays, some ultrasound and EKG. The dental clinic also had X-ray and was fully functional to do most extractions and some restorative work. Some of the patients moved between dental and medical and even on to eye checks and hearing tests to get the full benefit of all the services provided. Modern medicine and cell phones made it possible for our doctors to work with physicians back in the US to assess and offer expertise on cases. One young man, age 15, came in with a bullet lodged in his lower brain. The images were sent to a neurosurgeon stateside and also to a radiologist and a pediatrician. Together they concurred that surgery might do more harm than good and that he should not have it removed because of the risks involved with surgery. When seen, he was 2 weeks out from his injury and walking with minor assistance. The educated opinion of the experts, rendered from far away, were a great help to a family that did not know which way to turn. The most difficult cases we saw were the ones where we felt our hands were tied by circumstances beyond our control. The breast mass, the severe heart murmur in a younger man, the colon cancer, the “spells” that remained undiagnosed—all caused the team anguish as we conferred, prayed, and tried to find a way forward. In a place where few have insurance and the medical system is cash based, not having money for a procedure simply means that it will not happen. In the end, we tried to give some assistance to the hardest cases we faced, but all were daunting as radiation and chemo and surgery are scarce and mostly unavailable. Extended treatments often require travel abroad, something that involves another set of hurdles, including the necessary paperwork and large amounts of cash. After a busy week of seeing hundreds of patients, I was left with one predominant emotion: gratitude. Gratitude for what we were able to do, gratitude for the appreciative response of those we reached out to and those we worked with, and gratitude for all that we have here at home. In spite of the difficulties involved, overseas medical missions is productive in that it refocuses us on things that really matter: relationships, compassion, and the unity of all humanity as we occupy one fragile planet together. Yes, we are different but my goodness, we have so much in common. Whatever nation we are from, our bodies work in much the same way and malfunction in similar ways; our passion for helping our loved ones is undiminished by deprivation and scarcity of resources and our desire to be treated with dignity is uniform. My hope is that we did a world of good in our week in Belize. Realistically, I know that the impact was relatively small. Some would argue that the resources spent in taking so many people was not worth the benefit. However, I would argue the opposite. The seeds of love and care sown will continue to bear fruit for years to come and more than that, our team was changed. We all came back with a bigger vision of our place in the world and our greater responsibility for our neighbors, both here and beyond.
  4. jeastridge

    Nurses with Attitude

    Thank you for sharing. Well said.
  5. jeastridge

    Nurses with Attitude

    I appreciate your response. Nursing is a tough job, for sure. Thank you for working hard to be a great nurse!
  6. jeastridge

    Nurses with Attitude

    Haha. Yep, rarely does anyone fit either description all the time. But we can inspire one another to do better, right?
  7. jeastridge

    Nurses with Attitude

    I agree. It was embarrassing to hear.
  8. jeastridge

    Nurses with Attitude

    Consider two possible scenarios: Nurse A Nurse A enters the emergency department bay where a critical patient, in the process of stroke protocol lies semi-comatose on a gurney, surrounded by anxious family members and friends. She says, “There aren’t any rooms over in ICU. You all will have to spend the night here. I will watch over him, but I have 3 other patients I am taking care of. I think you all should complain to the administration. If you don’t, nothing will change. I know I’m outta here as soon as my husband gets a transfer.” As she leaves the room, her negativity fills the space just as surely as if she trailed toilet paper on her shoe. Nurse B Nurse B enters the same area to start an IV and hang plasma. She does her duties in a professional manner and asks the family if they need anything. “Well, the other nurse told us there aren’t any rooms upstairs. What are we going to do?” She replies, “We will continue to take excellent care of your loved one while he is in our department. We will be just outside the door if you need us. Please don’t hesitate to call. We will also be working diligently to get the patient to the ICU as soon as is possible. Is there anything I can do to help you all be more comfortable while you are here with us?” As she leaves the room, the family sighs but feels re-assured that matters are under control and that they don’t need to be as worried. As a Faith Community Nurse who often visits a variety of Emergency Departments to be with families who are in a time of crisis, I see all kinds of nurses in action and am able to observe their interactions with patients. Unfortunately, I have witnessed some Nurse A’s and a number of Nurse B’s. While many Nurse A’s may feel perfectly justified in their complaints and what they say may be true, it is disheartening to see and hear nurses complain to patients, especially in their moments of true crisis. What would Nurse B’s say to Nurse A’s? She would be polite and not condescending but she would say in no uncertain terms: Don’t vent in any way to patients and their families. Don’t tell them about your life, about how tired you are, about how many shifts you are working, about how low your pay is or about how your car is in the shop. They do not care. They are sick. They need your help. They do not need to be in a position where they feel they need to take care of you. Being a professional means working through the bad times as well as the good times. Work is not always fun. It is work. It can be rewarding but it isn’t always rewarding or fulfilling. There are times when it’s just plain old hard. Get over it. Work anyway. Show up early. Dress professionally. Do a great job. Make your team proud. In the end you will, most likely, experience some sense of satisfaction for doing your best. You are in complete control. You can’t change your circumstances and you can’t change what happens to you but you can always be in charge of how your respond. Your reactions are totally yours. Maintaining control of your attitude is what makes you stand out from other nurses. As Zig Ziglar said, “Your attitude not your aptitude, will determine your altitude.” The Big Picture Every part of your life experience matters and fits together to make a bigger picture. While a “dream job” may never come your way, every job teaches us something. When we are new grads and have to “settle” for something less than we expected, we learn to do our best, to be humble and to persevere, gathering whatever we can and growing through it. As we go through our professional lives, many of us are able to look back and acknowledge with great humility, that yes, that job that we hated so much during that season of life, was critical to helping us get to where we are today, doing what we always dreamed of. Remember, it is always about the patient. It is not about the nurse. Being self-less, not self-absorbed leads us along the path that brings light and life to our spirits. Contrary to our natural inclinations, when we serve others with a joyful heart, we find the true rewards that we were seeking all along. Are You an A or a B? Probably most of us are some combination of a Nurse A and a Nurse B, hoping that we are much more of a Nurse B most of the time. We can help one another along by not feeding the frenzy of complaints and instead by calmly and steadily working together to pursue true professionalism as nurses, setting great examples for one another to follow.
  9. Download allnurses Magazine Nursing As a Profession: Changes Through the Years Reflections from Rosalee Sites, RN, BSN, MA Memories of Early Days Cleaning our own bedpans in the soiled utility room...steaming needles and syringes after checking the needles for burrs...no IV meds...1 nurse and 3 aids on a 52-bed unit...no critical care units...no recovery room after daytime hours...smoking on the wards...doctors smoking!... Growing up in Elkins, West Virginia in the 1940s, Sites remembers wanting to be a doctor. Interested in all things medical, she knew from an early age that medicine was her destiny; but because of financial considerations in her family and some of the limitations of the time, she instead applied for, and received, a nursing scholarship to the Davis Memorial Hospital Program. After 3 years of rigorous studies in the classroom and on the job training which involved staffing the floor, she was awarded the coveted black stripe on her nursing cap along with her pin and headed to work in 1965. Graduating from a degree program during that time, meant that she had to work hard, repeating a good deal of her initial training, to finally get her BSN 8 years later from East Tennessee State University. "Nursing has been a wonderful profession for me, and I would do it all over again if I could." Working the night shifts on the wards meant that she was responsible for as many as 52 patients a night. She remembers making her rounds early in the shift and taking special note of those that might need something right away. One particular night stands out in her mind because it highlighted the importance of her role as a nurse and how the patient perceived her as being someone they could count on. While rounding, she came into one lady's room and the patient said, "You are here. I've been waiting for you." She asked, "Is something wrong?" The woman went on to say that in the daytime she had family around and there were lots of employees working but at night "It is you and me. That is the reason I wanted to meet you." Her statement stamped itself in Sites' mind, helping her clearly understand how important she was to her patients-they trusted her and counted on her honesty and care; she felt a sense of responsibility for their successful treatment and recovery and her role in it. "Nursing assessment skills are the most important tools we have even now. But back in the early days, they were some of the only tools we could employ: skin color, temperature, respiratory rate, nail bed color, clamminess, pupillary response-all of this nursing observation had to take the place of non-existent monitors." Sites says she can remember rolling a patient's bed into the nursing station with her, so that she could watch them while she charted. "There was just so much less that we could do for people during those times. Medications were limited as were tests. We had to do the best with could with limited resources." "Me, God, and the Telephone" Early on, Sites recognized her special skills in administration and after a few years of general nursing began to specialize in administration as house supervisor with coverage of the emergency room, a small 4 bed unit at the time. As house super she had to do bed placement, deliver antibiotics to the floors on her rounds, and cover the ER. "It was me, God, and the telephone," she remembers. Making necessary calls to physicians at home and running the ER which would be considered primitive by our standards today, was all in a days work. "As a nurse, I have been privileged to share very special moments in patients' and families' lives: being with them as their loved one takes their last breath, bringing a smile to a critically ill child, listening to an elderly lady talk about her family, helping a family member get their father who had dementia on his knees as was his nightly custom for prayer..." After getting her Master's in Organizational Management, Sites continued to make important pioneering differences at Holston Valley Hospital in Kingsport, Tennessee where she continues to practice today. She started the first state-of-the-art Emergency Department, beginning with 23 beds. To really understand what was needed and what was available in terms of design and functional capability, she and a team of other employees visited EDs around the country to borrow the best ideas from the all, eventually making the ED at HVH one of the premiers in East Tennessee. She also headed up a group needed to obtain a Trauma Level 1 designation and worked hard to make that hallmark of advanced technology and ultimate care in trauma part of her local hospital. "The Changes Kept Coming" As the years rolled by, intravenous antibiotics became commonplace; roller clamps and marked bottles morphed into bags of fluid which gave way to machines that counted the drops and delivered the necessary medications in the right quantities to patients. Scans, CTs, MRIs, EKGs, ultrasounds, robotic surgery, all become part of the daily routine for a changing profession. "Even though the changes kept coming, I always realized that the role of the nurse remained central in all of the care we provided. Our patients continued to count on us." Sites went on to clarify, "Your patients will remember you giving them medication for pain, for starting their IV, for inserting their NG tube but more importantly, they will remember you for listening to them; we used to have a physician on staff who said, 'If you listen to your patients they will tell you what is wrong with them.'" The advent of CPR and Life Support provided new ways to intervene at the end of life. "The first person I did CPR on was my own dad in 1965. Because he didn't survive, I worried that I had done something wrong, but later I realized that he had a long cardiac history and there was nothing that I could have done." With CPR came ventilation, ICU care and increasingly interventional medical care. "Continued Education is Critical" A lifelong learner, Sites revels in tackling new topics and continues to be a focused student. As a nursing leader at her institution, she took to heart the major importance of encouraging her staff and others to continue learning. She pushed LPNs to get their RNs, made ACLS mandatory for ED nurses (to loud outcries of protest!), prodded along the process of obtaining certifications in ED nursing. Along with all of this, she was visionary in understanding the critical importance of working with and training the EMS staff so that the pre-hospital care maximized the patient's chance of survival. "As professionals, we owe it to our patients to learn all we can and to push ourselves to reach out for more." She objects to ever hearing the phrase, "I'm just a nurse," and emphasizes the unique and special role that we enjoy as nurses who often are the ones seeing the bigger picture, the ones who are able to bring different disciplines together, the ones who translate what is in the EMR to both the physicians and the family. Our role has always been important but never more than now. Nurses as Leaders "Being a nurse has responsibilities and requires leadership." Throughout her career, Sites has taken seriously the role of mentor to other nurses, and finds it deeply disturbing to hear nurses complain about the profession she loves. "Maybe you have not thought o yourself as a leader but that is exactly what you are. You are a professional nurse and you will be a leader in whatever area you may find yourself." As her career progressed, Sites sought out ways to not only improve conditions within her hospital but also in her area. Helping to start a local medical clinic for the working uninsured and serving on a number of boards and committees, Rosalee continues to see part of her role in nursing as someone who takes on community issues as well. She has been known to quote Sir Winston Churchill, "We make a living by what we get, but we make a life by what we give." Evolving Uniforms and Lack of Uniformity In the early days of nursing, compliance with uniform standards was strict and adhered to stringently. Sites remembers, "We polished our shoes, ironed pleats in our aprons and looked forward to the day when we could earn the right to wear the black stripe on our caps." She laughs to think that they were also required to wear girdles so that there would not be any distracting "jiggles!" Sites states, "What we wear can help inspire confidence in our patients, because if we dress well for our role, it can help us and it can help them. Appearances do matter." Nurses in most areas were not allowed to wear pantsuit uniforms until the mid-'70s. Scrubs came out in the mid-'80s and a general loosening of uniform standards continued until recent times when many hospitals have adopted new, more consistent uniforms, including the requirements that all RNs (and other professionals) wear a certain color scrubs so that patients and families can have an easier time distinguishing between providers. Career Changes and New Challenges Most nurses would readily agree that being able to change positions within the nursing profession is one of the great benefits of our training. Sites is no exception. After spending many years in the ED, Sites wrote a grant to the Robert Wood Johnson Foundation and was approved to start a Parish Nurse (also known as Faith Community Nurse) Program in her community. Now, 20+ years later, she continues on as the director of the program, faithfully administering the growth from a start of a handful of nurses and churches to two different programs with almost 50 nurses total. "Our hospital system wanted to find a way to engage with older adults and I saw Parish Nursing as a great way to do this." After receiving the grant and getting the program started, Sites pursued innovations, continuing education for the group, and diligently encouraged all the FCNs under her leadership to meet and exceed expectations. "One of the primary roles of Parish Nurses is advocacy. They need to be informed, knowledgeable and caring. Sometimes, the nurse if the only person who really cares; is there anything more important than that?" she asks. Looking Ahead "We have come from a time when we could do very little for our patients to a technology-heavy environment that threatens to distance us from those we care for." Sites goes on to say that the very technology that improves patient care can also cause us to lose perspective in our personal lives, over-focus us on screen time and diminish the necessary personal interaction. "You must work on being healthy in mind, body and spirit, modeling a healthy lifestyle for others, refueling and renewing your strength so that you can continue to give." When asked about the future of nursing and the ways that we may need to improve, Sites goes back to the basics: education. There she sees systems that are producing new nurses with good textbook knowledge but less practical training; nurses who are equipped to pass the NCLEX but who are less equipped to do basic bedside procedures. "What happens, when we have graduate nurses that are not fully prepared is that they end up leaving the profession. They feel dissatisfied with their jobs and they change jobs, experiencing less support from their peers. "As mentors and nursing educators, we must pursue avenues to do a better job with training so that when nurses hit the floor they are at least able to have some level of proficiency so that they are assets and feel reasonably comfortable in their roles." Parting Words of Wisdom Through a long career in nursing, Sites has seen a lot: evolving from when we could do very little to extend or improve life to an almost hyper-interventional care time, she sees the need for balance, gratitude and grace. She continues to see nursing as one of the most relevant professions in existence, but one that cries out for its nurses to get back to their roots of truly caring for one another, both our patients and our fellow employees.
  10. jeastridge

    Gonna Quit: When Nursing Is Rough...

    My friend texted me a short note that spoke volumes, “Gonna quit. Just can’t handle this anymore. Work here is too hard. Help!” I read her note with sadness and tried to respond with a word of encouragement that might last longer than the appearance of the emoticon on her screen. Getting discouraged in our work as nurses happens to all of us from time to time. Studies show that nurses change jobs more than other professionals. In fact, the latest trends show nurses leaving the profession in greater numbers often for other lines of work but sometimes to pursue advanced degrees that will move them beyond the bedside and into higher paying positions. This trend, evolving over the past decade, has led to a large number of nurses with advanced degrees and many fewer who see their calling as staying the course in the arena of bedside nursing. Recently, a friend went to the local ER where she was to be admitted for an appendectomy. The ER was full and there were physical beds upstairs, but the lack of staffing by nurses kept patients on gurneys in the overcrowded spaces downstairs. This problem did not develop overnight but administrators scratched their heads, perplexed as to why they couldn’t attract and retain enough nurses to keep their hospital fully functional. “The RN Work Project reports an average of 33.5% of new RNs leave the bedside within the first two years” (https://minoritynurse.com/why-good-nurses-leave-the-profession/). Staffing levels in emergency departments and intensive care units in some places are better, with less critical shortages. Some have theorized that this is because those areas are seen as stepping stones to leaving the profession to pursue higher education. In other words, nurses apply for ED and ICU jobs more often, stay with them longer, in hopes of going to nurse anesthetist school or getting a nurse practitioner degree. At one hospital, administration is considering requiring nurses to work medical/surgical floors prior to having an ICU or ED job. While this may take care of the problem in the short term, what are some longer-term concerns we need to discuss? While the problem is widely acknowledged, and the proposed solutions are myriad, it seems that at times the remedies are knee-jerk reactions, running around with band-aids to address gaping wounds. While stop gap measures may be required in the short term, is it possible that a longer term vision might serve us all better? What can we do, as nurses, to help influence the conversation? Do we have a place at the table? Are we invited to give our input? What would you tell administration if you could sit down and have an honest conversation? A living wage is important While money is not the main motivator for most nurses, we all have to pay rent/mortgages and car payments. Having a living wage helps to take that off the table. Most nurses don’t go into the profession with the hopes of becoming fabulously wealthy, but all would like to be able to live decently and retire with dignity. Patient ratios matter Administration can ask nurses to do extraordinary duty from time to time but not on a routine basis. Taking care of more patients than you are physically able to is not only dangerous but demoralizing. It sends the message that “what you are doing isn’t all that critical.” By slowly eroding professional pride excessive demands on nurses in the forms of unreasonable staff/patient ratios takes the wind out of the sails of good nurses who thrive on doing a good job, not on cutting corners and making do with less than the best. [There have been a number of articles on this website related to this important issue.] Keep bureaucracy at bay Fears, especially fears of litigation, can lead administrators down the dark and dangerous road of micromanaging and over-control. It is a given that mistakes are bad, perfection is good but the road to excellence is not covered in more forms—it is instead, oddly and perversely opposite to trends, in the freedom to pursue excellence as individual professionals. The fear of mistakes and lawsuits keeps us at times in the straight jackets of compliance, endlessly clicking our computers while the patient suffers the consequences of our inattention, at times resulting in units where nurses spend their time congregated around computer screens and less often doing hands on care. Mentoring matters New nurses need connection, encouragement, supervision, training. When professionals long to flee their field after a few short months, something is very wrong. Part of the answer lies in what we expect from our new grads. Longer term preceptorships, lower expectations of independent function can work together to promote safety, collegiality and well-supported co-workers who want to stay and find reward in their work. While long term preceptorships cost money, they are an investment in the long term health of our institutions. A nurse who feels the brightness of a the future in his or her job will stay with it and be an asset to the profession as a whole. It’s complicated… It is important for all of us to work together to find solutions that fit our situations. With increasing pressures from within and without, hospital administrators daily find themselves in lose-lose situations, working furiously to simply put in place the “less bad” alternative. The answers to our current problems are many are far-reaching, extending from voting to informing our legislators, to speaking with kindness and courtesy to listening carefully. As H. L. Mencken said, “For every complex problem there is an answer that is clear, simple, and wrong.” For my friend who found herself upset and angry, a word of encouragement was just what she needed to get through the day and face a new tomorrow. When the going gets rough, we can all be that voice of hope for our co-workers in need. Joy Eastridge, BSN, RN
  11. jeastridge

    Renewal and Refreshment by Giving More

    It is the season to think about gift giving: we exchange gifts, food, parties. But as nurses, we sometimes find this a difficult season to work through; not only do we have more opportunities and obligations, nursing doesn't take a break or go on vacation-in fact, the workload can increase as some staff take time off. Conventional wisdom says that we have to take care of ourselves first, protect our time, plan special things just for us. Conventional wisdom would have us believe that self-care is the way to greater happiness and fulfillment in life. What if that is simply not true? What if we gain more by giving more of ourselves away? What if we find real refreshment and refueling by offering more kindnesses to others? What if conventional wisdom has things backwards-or maybe just overweighted on the idea that it's all about "me?" Two very different recent home visits got me to thinking about how we ultimately find refreshment and renewal in our personal and professional lives. First was the elderly gentleman who was difficult to visit because of the bitterness he seemed to have stored up in his heart. As he shared his memories of past service at this church, he ruminated on remembered slights from his peers and a lack of gratitude from the recipients of his volunteer work. It seems that although he gave of himself routinely, he begrudged the time and judged those he served to be less than worthy. As he nears the end of his life, he seems defeated, burdened, heavy, less than content. After visiting him, I left feeling sad for him and struggling with how to respond most effectively to help him find peace. In contrast, a gentleman across town of a similar age, economic status and faith community, has a definite twinkle in his eyes as I visit him in the nursing home. Before sharing his own concerns, he is anxious to find out about how my family is doing. His memories involve humorous stories of his own shortcomings in meeting the needs of those that stopped by his faith community house of worship; he told a tale of volunteering to fix a roof, identifying the problem and repairing it, only to have the resident less than satisfied with his labor. She called the church and told the secretary, "Those two guys that came by here to look at my roof? Don't pay them. They don't know what they are doing!" His laughter and easy going attitude served him well as a younger man and continue to do so now. What is the difference between these two men? They both volunteered to serve; they were both involved and gave of themselves. But fundamentally, their attitudes couldn't be more different; while one found fault and judgement, the other seems to have encountered life with a more open heart and a sense of humor, seeing others as worthy of his love and care. Fundamentally, the attitude of their hearts was different. As professional nurses, we meet both of these types of people daily and we ourselves have the opportunity to chose which we will be. The work we do remains unchanged but our attitude about our work is always under our control. We can work with resentful, bitter attitudes or chose more joy. In practical terms, how can we be more giving and experience refreshment in our careers by giving more of ourselves instead of less? By adjusting how we see our patients and their families instead of focusing on our own needs as much? By valuing others as we value ourselves? By forgiving quickly and letting offenses go? Here are some ideas of consider as you look forward to this holiday season where work may become more intense instead of less and people may act more like the Grinch or Scrooge than Tiny Tim. Stay centered. This may sound upside down and backwards but it's not! As we are able to keep ourselves centered on what really matters, letting the little stuff slide off our shoulders, we become the professionals that we want to be and are better able to offer excellent care to our patients. So start the day with a reading, or a moment of yoga, or some music that feeds your soul. Find your way to stay centered. Do something kind. Go out of your way to practice a kindness; the good deed may help bring refreshment when the well of energy and good will is running low. Going above and beyond may seem impossible, but sometimes it is just what the nurse ordered! Renewal follows. Say "yes" more. Oddly, as much as we want to protect ourselves and our time by saying no, sometimes it doesn't have the desired effect. Instead of feeling better, we become more self-centered and less giving. Ultimately, our inability to say "yes" to favors or opportunities, can make us more like Gentleman #1 instead of #2. This Holiday Season, let's all practice giving more instead of less. As Maya Angelou said, "If you don't like something, change it. If you can't change it, change your attitude." Happy Holidays!
  12. jeastridge

    Parish Nursing

    Hello! I hope I can help. I have been a Parish Nurse/Faith Community Nurse for 20+ years and continue to love this ministry as a wonderful way to serve and to put my nursing skills to good use. I think if I were in your position, I would start by looking over the Westburg Institute Website. They are located in Memphis. There is an annual symposium in April and you also might consider doing that. You can take an online course to train in how to be a FCN--there are many available. There is, of course, a cost but it's a great way to get started. Let me know if I can help further. Joy
  13. jeastridge

    Jewish Nurses Take Care of Synagogue Shooter

    Thank you for sharing. It is always uplifting to hear of the goodness of people in response to such an evil event. One of the earlier responses to this article was from someone who chose to make a donation to the employee fund at AGH--a very positive response, for sure. Joy
  14. jeastridge

    Jewish Nurses Take Care of Synagogue Shooter

    Wow! What a positive response and a great idea. Thank you! Joy
  15. A Horrific Event On Saturday, October 27, a 46-year-old white man, Robert Bowers, opened fire inside the Tree of Life Synagogue in Pittsburgh, PA, killing 11 and wounding 6 others. When he was taken to the local hospital, some of the nurses who took care of the shooter were Jewish. In the aftermath of the shooting and the mourning that follows, we have reason to be proud of our fellow nurses and their utmost professionalism in this incident. While shooting, Bowers shouted that he wanted to kill all Jews. During the shoot-out with police officers that ensued, Bowers was wounded and taken to the local hospital, Allegheny General. There, nurses and doctors, some of them Jewish, provided medical care to the perpetrator. The Shooter Becomes a Patient "He was taken to my hospital and he's shouting, 'I want to kill all the Jews'," Dr. Jeffrey Cohen, president of Allegheny General Hospital and a member of the Tree of Life Synagogue, told ABC. "The first three people who took care of him were Jewish. Another nurse, whose father is a rabbi, came in from a mass casualty drill and took care of this gentleman." (Pittsburgh synagogue shooter tended to by Jewish doctors and nurses, officials say | Fox News) Dr. Cohen went on to say, (Why Jewish hospital president checked on injured synagogue shooting suspect - ABC News) Code of Ethics As nurses, we don't spend a great deal of time memorizing or going over the Code of Ethics that guides our profession, but all of us find our daily practices affected by the principles it sets out. The Code invites us to be better, to look higher, to expect excellence from ourselves and from our peers. The American Nurses Association Code of Ethics for Nurses outlines the responsibilities nurses have to go above and beyond in providing competent and compassionate care. Provisions 1-3 of the Code, especially apply in this case and include the following statements: 1. The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person. 2. The nurse's primary commitment is to the patient, whether an individual, family, group, community, or population. 3. The nurse promotes, advocates for, and protects the rights, health, and safety of the patient. (http://nursing.rutgers.edu/civility/ANA-Code-of-Ethics-for-Nurses.pdf) The Code goes on to list 6 more provisions that further define the nursing profession. Nurses Rise to a Higher Plane Regardless of our personal feelings, views, traditions, we are called upon to rise to a higher plane when it concerns excellence in patient care. As we put aside our horror at the atrocities committed in mass shootings, we live into our professional calling as nurses, caring for the deserving and the undeserving without distinction. In this day of deep divisions, we hear media outlets endlessly pontificating on their opinions about how some people are more deserving of care than others. We hear discourse that seems to imply that the "good" people deserve better care than the "bad" people. As Daniel Patrick Moynihan reminds us, "'Everyone is entitled to his own opinion, but not to his own facts." The fact is that our Code as nursing professionals does that allow us to make judgements about who is good and who is not good. We simply provide good care to call, doing out best each time, allowing the judgements to go to our Higher Powers and others who end up in the position of making such decisions. When we witness an incident of terrorism such as the one that took place in Pittsburgh on Saturday, we are, once again, reminded of our ethical duties as nurses-called to care for our patients to the best of our abilities every time regardless of their criminal record, immigration status, drug usage habits, insurance, fame, power, position. When we practice nursing while living out the Code of Ethics, we become more than just one nurse; we join the body of nurses worldwide who care for others in their time of need. We learn to give of ourselves sacrificially, putting the needs of the patient first, advocating for them if needed, regardless of whether or not they merit our care. By doing this, we remove ourselves from the base position of judging others, and we become instead, givers: grace-filled, seekers of wisdom, people who long for the greater good of all and do all that we can to help implement that in the world around us through our diligent and honorable practice. Thank You for Compassion Our thanks to the Jewish nurses in Pittsburgh who set an example for all of us. You remind us again of our higher calling and invite us to serve everyone with an attitude of compassion and in so doing, we become more than individual practitioners but a profession we can be proud of.