Paulthenurse

I didn't understand in my first weeks at a new job, why so many of the email auto-signatures, listed CNA. I am proud to work for a company, where every person... not already a nurse or having direct clinical contact with the patient/clients, strives to become a CNA. (yes, including the VPs). And they donate time annually to be in that hands-on position.

One more thing about nursing.... "it's rough out there." One evening the year I got married, and I was working in a trauma center, I thought a lot about marriage and having a family. There seated at the big table, where we all quietly did our paperwork, was a new police probie. That night there were a number of drug related shootings. His adrenaline was pumped, still breathing heavily, remarked... "man, it's rough out there!" I looked up at him, and made a comment I later regretted. Yep; and I see you have a Glock, a stick, mace, Taser, a vest, and some of you have a dog in the car. Or that paramedic next to you: with ladders, a hose, ax, bunker gear and air pack. Like the secretary's husband who as a soldier, swears a helmet, battle gear, m-16, and travels in a tank.... Me, I'm in here wearing a cotton shirt and a rubber glove. That year the CDC recorded in the centennial US, every disease known to man except for Small-pox. PPE and gloves were not a part of the lexicon when, HIV-AIDs, Toxic Shock Syndrome, Legionaries, were first encountered. Most of us had books, journals, and the MMWR, to protect us. The challenge and accomplishment was taking our combined education and experiences, then model and shape it to meet that individual patient's needs. Restarting that man's heart, giving that bloodied mother and child a chance to hug & cry together, or ease the pain of the cyclist' broken leg. The one I found most terrifying, was helping a toddler with asthma breath. A moment's tears turning into laughter, is worth a day's wage and the traffic driving home tired, & aching from work. I really needed to learn to drink coffee.

I am proud (and most days humbled) to be a nurse. People seek me out for my advice, my knowledge, my ear, an arm, a hand, (maybe my compassion... but that is something I don't quite understand, like having Grace). I graduated with a BSN in 1980, and only thought I would do this for 6-8years, before moving on to what I thought was my chosen path. 36 years later, I'm still a nurse, but also a husband for 31years, and three grown sons. (The "31"years has been the most challenging!) What most people don't appear to understand is, that labels don't always help with grouping persons into countable numbers, but can really add blinders and prevent you from seeing the whole person in front of you. Yes, there are a lot of gay and lesbians in nursing. Some would say the men are more easily spotted, but did anyone express the fact, there are more gay women and than gay men in nursing. I dated a number of ladies. And a few married women, I had a crush on. I used to think, how was that guy so lucky to find such a perfect and beautiful person as she. I think, most women in nursing, had that cookie image in their minds of marriage, family, kids, vacations, travel... that goes with marrying a doctor, lawyer, businessman, or computer tech. Those who understand nursing know, that as a nurse... it can be hard to make ends meet on one guy's salary. We don't make the engineer, "Mad Men", or high ranking military salaries that will allow one spouse to stay home comfortably. In some places, due to unions, and other perks: police, fire, and garbage workers make more money than a nurse. It's a conundrum.

One evening, I was at a traffic light with an assoc. nsg instr. 2 cars behind me. Suddenly, a horrific 2MVA occurred in front of us. So, I grabbed my lab coat, and stepped forward. Yep, was mistaken as a doctor by the cop, but anyway... helped the less injured lady with the gash across her cheek, assessed, VS, held pressure with gauze, temp.drg. and buckled her into the front passenger seat of the ambulance, and waited for them to depart. Mainly because all the others were needed for the other victim. As it turned out, the instr. and I were both heading to the gas station around the corner. I paid inside, because I still needed to wash my hands. She overheard the cashier ask me if I was an intern. I replied, simply no, I was "just a nursing student." As we crossed paths out at the cars, she proceeded to lecture me: Don't ever let me hear you say you're "Just" a nursing student or "Just" a nurse! You are The Nurse, or You are Their Nurse... She wanted to tell me, she saw what I had done, and was pleased with my skill and calm manor. Instead, I got chewed out for cutting myself short. Since then, I have been known as "Paul, the nurse." Many times since I have corrected other CNAs, nurses, once even a sleepy eyed resident (that was about to make a mistake). We have to empower ourselves to use what is in each of us: I don't allow a spouse to say, I'm "just the wife." Please remind them... It doesn't matter what's behind you name: LPN, MD, RN, Mom, Dtr, Son, or friend.... What matters is that it comes from your heart, flows down your arms and into your hands, So at that moment, when you lay your hands on that patient, You're the one ministering, nurturing, Nursing to that person. You care to give. You're the caregiver. The nurse.

wonder if the RFID card blocker would serve to protect again electro-mag interferance.

I've had a problem over the years with the magnetic strips getting scrambled from errant proximity to Xrays, CTs, and MRIs... Because of being a RN, leading codes, standing next to the patient during STAT Port chest...., escorting patients to the cath lab, CT, etc. It was a hassle to go back to the bank (my credit union) to have the strip recoded. That was one reason I try to not bring my wallet into my work area. Why don't you try and different approach: Go ask those in the Radiation Dept. what do they do or if they could recommend a type of wallet that would give your credit cards the most protection? Interestingly, I think most staff keep their cell phones on them. Are they prone to getting scrambled, due to the Xray machines.

It's amazing to read back at some of these comments. Read recently, that nursing is rated high of the list of most stressful jobs in the US. It also mentioned that nurses retiring or leaving after many stressful years (didn't say those from ICUs or ED), were showing S/Sx of PTSD. Why if they expect us to be more knowledgeable, work smarter, safer, longer, and harder... that the healthcare system look for ways to help the nursing process with more friendly EMRs. I still find it hard to believe we have to scan an armband and a blister packet, before you can give the medication to the patient. I never worked in a grocery store. I think of myself as more than a head of lettuce. And just because there is a computer information system in use, it's the person that cares to get it right. (garbage in-- garbage out). Had one patient that while attending, did have two ER visits and one 23Obs. Pt's mother tired to update next of kin, address,... info. Still came home with papers showing deceased (18mos/ago) father as emergency contact and a misspelled address. That's ridiculous.

What I find confusing is if I'm the HHC nurse walking in the door, and the Care Manager is now calling. Seems like a confusing mess for the patients and families. "Who are you? Who are they?" I don't see how a duplication can save anybody any money.

I wish I had spotted this topic earlier in my career. I graduated with a BSN in '80. My internship and first job was in the same regional CCU. Yep, Paper charts. Two things back the early days was when all disciplines started charting in the same "progress notes," rather than physicians on one color paper, nursing on another page & color, and other therapist under their own tab in the chart. "We" thought it was wonderful when all progress notes were merged onto the same page and time-line. Information, events, and thoughts flowed smoothly. The other piece of charting in critical care areas was a 3-page, trifold sheet (front and back) that included everything in one place. Over the years I have seen a number of versions.... What was great for us nurses, is that once a year the form was taken thru a process where everyone had input into its updating. Most importantly, it flowed as to how the nurses thought and performed their task for that patient: If the B/p was dropping, the new drip was started and titrated. ABGs were performed, the vent changes were made. Rx given, urinary output, cardiac output, etc. It flowed. And at the end of a rollercoaster day, you and the doctor could look back objectively and see if things were truly worse or acutely a bit better. Now that I do (the higher tech) home health care with wounds, infusions, trachs, and the sort... I find many of these EMR programs are written for the revenue generation. The nurses who gave input into the program were either ignored or were not real-world nurses in the field. The configuration of questions does not follow a clear thought process. Some of the programs require you to be "live" with a good internet connection. That's hard when sometimes in a home where that part of the county has little/no cell service. One system I worked with, required over 100 clicks/screen touches just for the simplest nursing visit. Typical home health days of 6-8hrs driving and visiting patients, still requires 3-4hrs of charting time later that night. One beautiful example is when you determine the patient must go to the ER: 911 is called, physician has been notified. You then call your office, where they are able to see your visit, notes, VS, orders, current Rxs, allergies and is then able to e-fax it to the ER-charge nurse, before the patient arrives.

That's what I like about nursing. You can learn something new everyday. Do you think the Girding will help in the fight against the mosquitoes and Zika virus in FL.?

I think we've all had one of those shifts.... yep... here comes a tear with the chuckle.

When I was a student 40years ago (OMG, did I really type that?).... In the '70s, there was so much Affirmative Action within the government and space industry. I didn't think guys would ever get a fair shake at a engineering or research job. I could not go in the initial direction for other reasons and because of a sick mother, so I stayed home and commuted to the local university. There, I saw nursing and the guys in nursing as "reverse" affirmative action, that could work in my favor. I only thought of being a nurse for 6-8 (no more than 10) years. Then I would retool to my original plan. I never wanted to be a doctor (yes, people have asked too many times). The friends I knew whose parents were MDs, were wild kids, who never saw their parents, except for two weeks to Hawaii or Europe. WELL, 36years later... I'm still Paul,the nurse. You get to do more with your hands and your heart than almost anybody in the world. You nurse, treat, clean, teach, listen, laugh, heal wounds, "minister/nurture," and sometimes the important times are just to sit and hold a hand. I call those the "cheap thrills!" It only took a couple of moments. My job may have been to help restart hearts, lead a Code, work hard to prevent a Code, and sometimes pronounce a patient at 0530. But, the night when the little lady was too scared to close her eyes for fear she wouldn't wake in the morning.... The night when you realize the man is "the man" who walked thru history with the famous, but this night... he wants to tell you a story about Elvis. You are humbled in the presence of others. You are the nurse. They all love and appreciate you for being there for them. (p.s. if you let them call you the "male nurse," it means they will usually take advantage of you.... but that's another time.) Let me end with this: ...you will end a shift or leave a housecall, and think; wait, I got more out of that than I gave. ...you will be walking down mall with your family, when you're blocked by persons you can't recall the faces or names... embracing you and introducing you to the husband who was then on a vent. or was in the ER post MVA or GSW. They will remember you. "This is my granddaughter, I wanted you to meet." Mean-while, your little son is asking my wife, "why does daddy always hugging on people?" (I heard her say twice, "come-on, he'll catch up with us.') And you wonder why you became a nurse.

Wallet just gets in the way... I used to carry it, and yet as soon as I got to work, (35yrs ago) it was into my bag or locker. My class ring got tied onto my scrub's draw-string. I think it's been in my wife dresser for years now. I started out in CCU/ICU/Trauma, where at lease weekly, I would have to change into clean scrubs. Now days, I'm a wound & high-tech homehealth RN. Too much in my pockets as it is.