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  1. jlindsey

    My Mother Was Right

    When I was a young girl growing up in America's Mid West, my mother loved nursing and thought that her daughter should follow in her footsteps. It was her dream that helping people was a great profession and she wanted me to become a nurse when I grew up too. However as I grew up my dream was to become a teacher. I felt that that was the career that I wanted for myself. While in high school there was an event that impacted my life deeply. A friend of mine from school was a foster child. On a couple of occasions when I visited her in her foster home I met three younger foster children, twin girls and their younger brother, that lived in the same home. After a few months the three young children were returned to their biological father. It was heartfelt to see them go but that is how the foster system works. A few weeks later what I learned hurt me to the core. What I learned was that all three of children had been hospitalized. After some time of being admitted one of the twin girls was pronounced dead. Her father had beaten her repeatedly until she became unconscious. No reason was ever known to me. However what I did learn was when she hadn't regained consciousness one night that the next day he took her to the emergency room stating that she had fallen off the swing in the park. No one was fooled. When I was eighteen I got married and soon after at the age of twenty became a mother myself. Even though I did not go to college straight out of high school, it was still in the back of mind that I would be a teacher. At the age of twenty two my dream came to pass and I went to college and obtained a degree in Early Childhood Education. My first position was as a substitute teacher at an elementary school. As all mothers, she still tried to persuade me to become a nurse. She must have saw something because she just would not let it go. After a few years of teaching I felt that I was missing something. I wanted to do something to help others. I decided to become a foster parent. My mother thought the best way for me to help people would be to become a nurse. She was persistent if nothing else. After a couple of years of being a foster parent I was ask if I would be willing to take an infant with medical needs. How did I feel about this? Was being a foster parent for an infant any different from an older child? What was going to be different was my thoughts? I can do this! First I took a baby from the newborn unit of the local hospital that had been born eight weeks early. He was so tiny; he still weighted less than five pounds. But I cared for him and nurtured him until he was able to be placed. The next child I took was an eighteen month old with Tay Sacs disease that had been abandoned at the same local hospital. The third child was a fifteen months old battling leukemia medical needs infant. My leukemia baby was such a sweet, happy, loving child. The things I feared about becoming a nurse (holding a child so blood could be drawn; or placing a small needle so chemo medication could be infused or even the thought of sticking a needle in this precious child myself) were things I learned to do. After fifteen years of being a foster parent I realized that my mother was right, I was meant to be a nurse. I returned to college once again and attained a degree in nursing. Better late than never so at the age of forty four proudly passed my state boards and became a registered nurse. That was well over a decade ago. My mother is now a resident of heaven and I know she is proud that her only daughter followed through on a dream that her mother saw in her and became a nurse like she was.
  2. I am a RN working that time on a neurological unit for rehabilitation in a foreign country. Patients have been transmitted from hospitals frequently. Many of them came from countries all over the world to receive treatment; a lot of them called it their last hope. Patients of all ages, complex diagnosis and often depressed about their situation. After receiving the shift report this morning I started my morning rounds. One of my patients, Mr. P. 65 years old, hemi paresis and aphasia after having a stroke, sitting in a wheelchair. A tall and slim man, one of the patients I will never forget! This day he should be transferred back to our unit. He was placed to the hospital for the last two days because of his suicidal intent. Since that day he was admitted from the hospital he often refused therapies he was scheduled for. Every assisting in ADL's seemed a torture for him. He rarely answered questions by using his hands and mimic. Weeks went by and nothing in his condition changed. By the time other patients learned to walk and speak again his progress remained the same. His wife was always worried about him, she visited him nearly daily for several hours. Pictures from their holidays and one of their marriage were placed on the night table in his room. While taking care of other patients that shift, Mr. P.'s wife appeared on the unit. She spend time waiting for me, I remember never seen her pale and silent before so I went over and asked her how she felt. That moment she took me next to her and offered me a family tragedy. After receiving several treatments against brain cancer, they finally saw their own daughter dying in hospital at the age of thirty years. The only child they ever had. She and her husband could never accept what happened; it was the deepest impact and took still part of their lives. She looked overwhelmed; tears were running from her eyes. "He is afraid of ending up the same way his only daughter did." She said. I felt frozen for a moment. My eyes were fixed on her lips, catching every single word she spoke. "The only way he sees for himself is to attempt suicide." I sat down with her. "It worries me that he will never reach his rehabilitation goals". During the following days and weeks I talked a lot to him, hoping to change his mind. I told Mr. P daily what a wonderful wife he had. The only family member who was with him and ready to go through everything what would come cross their way. That every ones time on earth had his own frame but that he was still here. And whatever brought you down lets you get up stronger. He sometimes smiled at me. While starting another morning shift, the nursing assistant was running back to me, telling me that Mr. P. was not in his bed and could not have been found on the unit. No one else had seen him this morning! I went to the room to convince myself. The bed was empty.... The bathroom... nothing! BUT the wheelchair was missed! Attempting to call the physician and the police I grabbed the phone. Before my fingers could dial a number, an incoming call reached me. It was Mr. P.'s wife. She told me that her husband would be in front of her gate, sitting in his wheelchair. She sounded upset and happy the same time. My heart dropped down. "Today is my Birthday, my husband wished to attempt."She said. From that day Mr. P.'s resources improved and he was finally discharged to a concept of assistant living. All our team members were still motivated to reorganize our patients ADL's and assist them and find a solution to help them to move forward and reach their goals. There is only one thing no one can give you.... It's your own motivation!
  3. fetch

    Running the Spring Marathon

    I used to work at a theme park, and the 2 weeks around spring break were unofficially known as "marathon" because we went from weekends only to daily operation. But since most of the high schoolers only have one week off, and a lot of summer people haven't been hired yet, everyone winds up working 60+ hour weeks. Pay period weeks ran from Monday through Sunday, with only one mandated day off per pay week, so it was common to work more than seven days in a row. The upshot of it all is that after marathon, everyone but a barebones staff gets two or three days off, and sleeping in for the first day is AMAZING. I haven't worked as a nurse in a hospital, so I don't know what the timing of the marathon shifts is like in that setting. But for my school district, now that we're back from spring break, it's clear that the end of April is our spring marathon. I've had more kids coming in each day, for an increasing variety of reasons. Within a two week time span, we have scheduled three field trips, a visit from the mobile dentist, an immunization clinic from the health department, and an open house. Spring allergies means that everything is coated yellow, and asthma kids who haven't had issues all year are showing up daily with wheezing. There's been a bunch of new students registered, more in the past 3 days after spring break than we had in all of March. We're looking ahead to the end of the year and cleaning up health folders, as well as putting together allergy and asthma packets for kids who are returning. New medications, changed medications, the discovery of kids who were supposed to have medications all year but parents have just been sending inhalers in their backpacks every morning and never taking anything to the nurse (seriously!). Kids are wound up and worn out, and fights are more frequent. The winner for today's "Kids Are So Strange Oh My Gosh I Can't Believe We All Used To Be Tiny Humans Like That" Award goes to whichever 3rd grade boy decided to roll some scrap paper together, pinch it up like a joint, and then try to smoke it in the bathroom. (The runner up to this award is the kindergarten girl who decided one part of the playground equipment is a "jumping board" -- it's like a diving board, but you just jump onto the mulch. She thought it was still ok to try to dive off it though.) And since the weather's warming up, there are 5k runs and races all around town every weekend. (Two of which I signed up for 6 months ago, not realizing how much would be going on this time of year.) We locally had a 16 year old die in a half marathon just last month, and there's been more reports from across the country of people who thought they were perfectly healthy but die before crossing the finish line. This confluence of increase in work load and personal matters on the weekend means that I am collapsing into bed late and getting up early, with only one day a week to really rest. It's spring marathon all over again, and I'm only on mile 5. But I keep this quote in mind, and I know I can keep going.
  4. Blueorchid

    Warm Fuzzies Story

    Your story isn't unlike many others I've read, carefully reading the printed handwriting on your flow sheet as the night shift nurse gives me a detailed list of your injuries. You're young, I don't need to see your birth date to know that as I glance up from the cubby outside your room to look at your face, only nineteen years old and your first trip to a level one trauma center. You were the driver in the accident, I'll later see pictures of your car wrapped around a telephone pole on the local news station. It was pretty bad, you weren't breathing on the scene so the first responders got to you ASAP. Your 15 year old friend in the passenger seat was taken to a different hospital and discharged a few days later but you, the sickest, you came to see us. And your tox screen was pristine. The accident was in no way your fault. But it left you with a laundry list of injuries: a broken pelvis, long bone fractures in your leg now placed in traction, and a sneaking suspicion of mine that your head cracked the windshield when you so abruptly stopped. I'll tell your mother who is dutifully keeping watch in the back of the room that we needed to fix the things that would kill you within the first few hours before going back to fix your leg. Its hard to believe that when a traction set up is the first thing that hits you when you come into the room but at one point and time you were that sick. You're still on a ventilator that first morning of three when I'm your nurse. You have a nasogastric tube and a central line with a pretty basic list of medications, pain meds, sedation, and fluids. and your vent settings are low enough that I know your lungs didn't take a beating through all of this. Its a good sign, they might even be able to extubate you soon if only you would start following commands. So I start my day like any other, gathering information from the computerized charting, the list of systems. and any concerns given to me by the night shift nurse. Its time to wake you up, coaxing you slowly out of the propofol haze so I can try and get you to put your thumbs up when I ask, wiggle your toes, stick your tongue out- anything so I know you're hearing me in there and can understand me. I encourage your mom to help when I wake you up, sometimes I think hearing that familiar voice helps keep you calm when you can't talk and are breathing through a soda straw as multiple people scream at you. We know its not a good idea to yell at someone rapidly coming out of sedation but sometimes we do it anyways... You respond little by little, the slight shift of a foot, you even crack an eye open at your mom's voice. I go slowly, remembering the previous shift's warning that "he wakes up like a bear." That adds to my suspicion you might have a head injury. Not breathing after the crash, lacerations to your head, and that snap- like turning on a light switch from a groggy propofol daze to "WHAT'S GOING ON?" in 0-6 seconds...yeah, its not confirmed just yet but we nurses don't give someone the term "head-ey" without doing out research. Fortunately the "bear" doesn't rear his ugly head and I get enough of a response that I'll consider that almost following commands- for now. Unfortunately it doesn't get any better than that for me, I can't give you the highest neurological assessment every time I pause the sedation, but every once in a while I do. And I can lower your sedation to give you the best chance to respond without the risk of you yanking your breathing tube out. Your vent settings come down even further. Things aren't so easy that night. Apparently you have a few episodes where you thrash around and try to self-extubate- a four letter word in any ICU. It scares your mom because the night nurse who comes in to tackle you back down to the bed doesn't have anyone else behind her, so there she is, pinning one arm down as the nurse takes the other and puts you back to sleep. The cavalry it seems, is either busy at those moments, or they can't hear her. You happen to be one of the lucky patients in a corner room which makes things even more difficult. Your mom starts to feel obligated to stay and the sedation goes back up, you follow commands sporadically when its safe enough to pause the sedation but fortunately your vent settings stay low. Family members come and go on day two because your mom looks exhausted and your family all agree she needs sleep. But the second day I have the same success, I start to bring your sedation back down. Your friends even come in, your buddy from the accident is in a wheelchair but he's doing okay. I later text my boyfriend (who I learned was at the wreck and transported your friend) that your buddy looks well. And then the tipping point happens where I think we might actually be able to take that tube out. Your sedation is low enough that when the trauma team rounds on you in the mid afternoon the second day I hear their attending ask why you aren't extubated. "He isn't following commands, we're working on it though," I say, representing the critical care side in the ICU. There goes the trauma attending, a tall and imposing military man who scrubs with hand sanitizer, walks in the room, puts his hands on your traction frame and barks out in his best drill sergeant voice "open your eyes!" Oh...well hello there. Caught between thoughts of men...and you little... I watch as you wiggle your toes, put your thumb up, and stick out your tongue. Okay...you're one of those guys. The night nurse and myself were women, so is your mom (obviously)...maybe you just need us to be mean...or men. And note that neither myself, nor the previous nurse, nor your mother are soft spoken...you apparently just like to listen to guys instead of us. Your mom and I share a satisfied glance and she starts to tear up and hug the doctor...its a sign you're getting better. And I could tell you plenty more stories. When you actually were extubated neither the Drill Sergeant Attending nor the nurses could get you to say anything although without the propofol you did follow commands. In fact the only word I got out of you was "broccoli?" immediately after you were extubated and started spewing green florets everywhere (where were you packing that by the way? I had your NG tube on suction for a full hour before we took the tube out). Or the time where you, acting head-ish, (which we would later learn was because you were sporting a DAI...) wiggled all of your 6 foot 2 frame to the edge of the bed while in 30 pounds of traction and tried to flip over on your stomach. Oh yeah you were strong...strong enough that when I called a nurse in to help fix the sheets you nearly picked me up off the ground as we turned you on your side and you somehow got your arm around my waist. Frankly I'm not sure how it happened either, but by the end of the third day your mom was asking where she could leave a comment card about my care. And in the week after she always took time to say hello to me in the hallways, as did your brother and your aunt. I even remember one night where I helped your brother who was panicking because he saw your arterial line go flat (you were flapping your wrist around) and I kept your arm still as he helped me re-zero the line. You came in once for a follow-up visit too. You were talking then, all the lines and tubes out of your body, and a knee immobilizer on your leg. Your voice was still soft and quiet as your mom introduced me. You didn't remember me specifically but I have a feeling you knew you had spent some time there. It was okay, I had the biggest smile on my face. You're only the second patient I've seen that came back to the floor and recognized me in some form or another, even if it was your family. It felt good. What feels even better is seeing the segment of you after I saw pictures from the accident, 8 months later, where you and your friend are standing tall. There's not an ounce of hesitation or softness in your voice, just a little hitch in your step as the camera pans out. We fixed you up and in return you're hosting a blood drive to give back to the community. I keep staring at the screen as I watch and notice my eyes getting a little misty. You can bet I'll be there. I can't tell you how it feels to see someone I've cared for look like he blends right into the crowd. Oh I know things aren't the same, and this experience will probably shape you for the rest of your life. But I'll look back on that day and when the shift is rough and things are going to hell in a handbasket I'll be able to say this is why I do what I do and know that every once in a while, I do make a difference.
  5. Joyful2bee

    I Had No Idea!

    H. was scheduled for the removal of a colon polyp after a colonoscopy failed to reach the tissue for biopsy. My husband was a very obese diabetic, who had recovered from a Wallenberg Stroke four years before with only a residual weakness in his balance center. His return to his job four months later demonstrated great determination and strength to endure the rigorous therapy required to achieve this recovery. These qualities helped him later as you will see. Responsibility, Loneliness, and Fear We arrived in the pre-operative area early for the prep for the surgery. I watched as the staff rolled my husband of 35 years away from me into an area where I could not go. I had been his advocate and caregiver after the stroke and felt very protective and responsible for him. I felt so helpless and anxious for his well being now. The thought that surgeons are human and can make mistakes hovered in my mind. While waiting for our son to arrive, I felt so alone and helpless. As soon as he arrived I felt his support shoring up my strength and calmness. A family member needs someone to help them spend the long hours that tick by so slowly during the surgery and recovery room care of a loved one. They don't know if there will be complications. Encourage them to call someone if they are alone. Regardless of years of experience and understanding of how things go in the hospital, I felt very alone until M came. Anxiety of Potential Complications So we waited. M, our son, was concerned that they might not be able to inflate the weight of his father's abdominal adipose tissue for the lap surgery. Sure enough, the surgeon came out and told us they needed to make a mid-line incision to reach the polyp. We understood and I gave consent. Soon an anesthetist came out and told us that three different anesthesiologists had been unable to put a central line in my husband's neck because it was so short and obese. I gave consent for a PIC line. Stress was mounting! What else could go wrong? What if he had another stroke? What if he had more complications? Even with the information given to the family, anxiety can run rampant especially when there are already complications. We soon found out about complications. After his surgery which actually went better than it started, there was no bed in ICU, so he was placed in CCU overnight for monitoring while on an epidural drip. Exhaustion His O2 saturation dropped into the 70s so he needed oxygen. He had a nasogastric tube and was supposed to be using his CPAP for his severe sleep apnea. Trying to fit a CPAP mask over a nasogastric tube was impossible to do. So we kept the oxygen flowing and raised his head slightly. I had been an ICU/CCU nurse for 17 years and didn't mind helping the nurses in the unit. During the night in a confused state, he repeatedly removed his oxygen mask. So about every 15 minutes the O2 saturation alarms declared his dropping oxygen level; I would hop up quickly and put the O2 back on his face. Finally, in exasperation or desperation, I ordered him to put his oxygen back on! He glared at me and said, "NO!" and removed it again! I am a very kind, polite and nice person, but was severely sleep deprived, had lots of stress, and worry that day. I said something I would never say normally. "Fine! Take the oxygen off! When you pass out, I'll just put it back on again!" I believe the nurses realized how exhausted I was and told me they could watch him so I could sleep. Yes, people do not behave normally when they haven't had enough sleep and are stressed out! Ask for a chaplain to help the family member be realistic about what they can do and how much sleep they need and make them leave for a while. Need More than Reassurances Please deal kindly and compassionately with the family's irritation or anger. Remember how many times someone has told you, "Don't worry, things will be fine." But they weren't? Words don't always help. Allow the family to express their fears to help them. It helps just to know someone is listening. Remember they are turning their beloved over to doctors, nurses and staff who they have never met before, who may be very busy, and who may not understand the patient's requests or needs. Then there are more "What ifs." "What if he develops another problem?" What if he won't be able to go back to work or his hobbies? What if...?" Believe me, there are many imagined "What ifs." That night one nurse did something I will never forget. My husband liked to be cold so there was a fan blowing on him. I like to be warm but I wanted to see him and him to see me at all times. So I pulled the recliner to his bedside and faced him. One angel brought a pile of heated blankets and without being asked to literally tucked me in! I never felt so cared for since I was a child! She understood and was so kind! I slept some after that. If you can, take time to listen or offer a small kindness for the family. Offer to call their pastor, the hospital chaplain, or the supervisor. Advocacy and Responsibility After a couple of nights, the epidural was removed and the doctor ordered Percocet two tablets every 4 hours for pain. I know the doctor was trying to keep him comfortable and considering my husband's size and history of back surgery and sciatica he ordered a large dose. The thing he did not consider was that my husband was narcotic naive. After one day H could not sit up; slept all the time; drank very little; and ate nothing. So on day three the doctor came and told my husband in no uncertain terms that he "had to get up." The doctor's tone of voice was the one they use when they are being firm with a manipulative or lazy patient. I was a bit upset that he assumed that H was lazy! But I knew something else had to be done. Since I knew H was not lazy. I began to worry that he might have had a second stroke. After several futile attempts by the staff to get H up, I spoke with the hospitalist that night. My husband had a high tolerance for pain, was very independent, and absolutely not lazy. I had to be his advocate. The hospitalist decreased the Percocet. As H came out of the drug-induced stupor he started acting like himself. He refused any more pain medicine as soon as he was lucid enough to understand what had happened. He related how he had been having hallucinations, confusion and terror attacks! Finally, he was moving around and helped staff get him up. He preferred to have pain rather than losing control of his own mind. It took physical therapy three weeks during his stay and after his discharge to increase his strength to near normalcy. Fears Being a nurse I know and understand that doctors and nurses are people and they make mistakes. We all do. But when my loved one has so many problems and complications I could not help but worry about mistakes or misjudgments being made. Plus there were always the questions that caused fear: How long will he need to recover? Will he be able to go back to work soon? (He loved his job.) I knew he had lots of sick time and had a good stable job but some patients don't. Some families may be very anxious about how to pay for the hospital stay plus the tests, IV fluids, lab work, radiologist bill and so many bills for so many treatments. Get them someone from case management to help them navigate this sea of bills they will receive. Reality: Complications After 11 days for what should have been a three-day stay, the staples were removed and H was discharged. But that is still not the end of this story. Three days after the staples were removed it was evident that his abdomen had not healed well. The wound dehisced in four places. The largest area was a tunneled wound 1 inch by 1 ½ inches and two inches deep in the middle of the incision. It took four months for the areas to heal. I cleaned and packed them twice a day for him. Imagine the stark terror of a non-medical person if they had seen their loved one's wound opening up and then having to treat it. Conclusion So family members need their own nurse? Well, not really. They just need lots of understanding and compassion from the ones caring for their loved one. We know nurses cannot do everything. When you cannot help in some area ask for help. But try to understand what the family is going through. Remember, "Walk a mile in someone's moccasins before you judge them." A lot goes on that we don't know about in the family's mind.
  6. Sabr

    To My Dear Fellow Nurses

    My nursing journey has been quite an interesting one; in a matter of 2 years post-graduation, I managed to work in a hospital, in a school, in home care and shortly I will be a travel nurse. How did I do it? Long story, but thanks be to God. What I will briefly share with you is how I came to love Home Care because of how much it blends with my personality and future endeavors as a nurse. From my little experience in Home Care, there is a greater level of flexibility and time to complete all nursing tasks efficiently. This is very different from the hospital setting where time management is key as the pressure is so high to complete all tasks within a limited time frame. Some days at the hospital were heaven; I dotted all my I's and crossed all my T's. Other days, I attempted to do the same and managed only to keep my patients medicated and alive. To all you new nurses out there who can't stand being in the hospital sometimes, I have been there. Sometimes you feel that nobody cares. Sometimes you feel no one has your back. Sometimes you feel your supervisors are of no help, sometimes you feel time is given to trivial things while the more significant aspects of care are not addressed. Sometimes you want to quit. And some of us do. But I am here to tell you, hang in there. It will be okay. Mariann Williamson once said "Our deepest fear is not that we are inadequate, our deepest fear is that we are powerful beyond measure. It is our light not our darkness that frightens us." This quotation could not be truer in our beautiful profession. In a profession where critical thinking is an essential survival skill, where young and old nurses work together, where some nurses are bullied, where each hospital has its own P & P, where we sometimes doubt how competent we are based on the judgments of others, where gossip is rampant, you have to know your fears and overcome them in order to be successful. As nurses, we fear imperfection because imperfection translates to poor patient outcomes if that imperfection causes the patient to be directly affected. But we mustn't fear to be perfectly imperfect. In most cases, we tend to ignore our gut feelings in order to prove ourselves in some way or follow what everyone else is doing. My advice is: refer back to the above citation and remember never to be afraid of your light. Your light will shine brightly only if you let it. Be honest and forthright but never darken your light! Always make the best choices for your patient regardless of what others say whether in home care or the hospital or any other setting. Never quit before exhausting all of your major resources and making your voice heard about what caused you to decide that place was not a fit for you. Leave on a good note. Always have something better lined up before transition into another position. Make the best choice of which nursing niche would fit your personality and your life. And love it. Our profession is not an easy one; no one ever said it was. And nothing in life is. But it can always be an empowering and enjoyable one. As a new grad who was stunned at the difference between clinical rotations and being an actual floor nurse, I went through a phase where I hated being a nurse and thought: "This is not what I signed up for!" In retrospect, however, that uncomfortable period in the hospital is what makes me the nurse I am today only two years into nursing. And I could not be more proud of myself and all the other nurses that are hanging in there despite the multitudinous challenges. Back to home care, I see myself working in home care for years to come even if it is per diem or part-time. It helps me be the nurse I always wanted to be- a nurse who successfully blends the art and science of caring and being fully present. I love my job, my life and myself. And I believe these qualities are what make me a great nurse. And consequently, I have gained the confidence and self-assurance needed to forge ahead and explore the smorgasbord of specialties in nursing. I have never been more excited in my life and I hope my enthusiasm is contagious because I want the same and better for you.
  7. madwife2002

    I Am Passionate About Nursing. Are You?

    I love my job! I guess I am one of the lucky ones in nursing these days but I actually feel I make a difference. Since February I am no longer clinically based but I am an Educator for a big company who treats me well. I travel a lot and that could be a problem for some people, It is never predictable and you change your path hourly, daily, weekly as situations arise. I make my own schedule, being flexible is a key word in my life and I have to be prepared to drop everything and run should the state arrive at one of my units. I have a large workload 15 facilities where I audit care, and plan staff education around what I find is substandard. I work with each staff member individually if they have needs that need a little bit more attention. The patients that indirectly benefit from whether I am successful or not number greater than 700. I have been an RN for over 21 years, which sounds so long, yet it has flown by. I have been very fortunate in my career but that doesn't mean I have had it easy or that things have come along by chance. I have had a very structured career pathway and I set goals along the way, I always set long term goals of 5 years. Each job I have had, I chose carefully, I never settled for a job just because I had to. I worked hard and I studied hard. Mistakes were something I never ever anticipated would happen, there were a few along the way but very few clinically, my mouth would get me into the most trouble! There were sacrifices along the way, mainly time. Sometimes getting where i want to work has taken years. Being passionate about nursing is something I am not ashamed of, it can frighten some people but mostly it has been received well. I thrive on knowledge and I have never been afraid to challenge, I hate to be dismissed so I am like a dog after a bone. What I have found along the road is that the majority of people hate to be challenged, but we are not sheep we need to challenge because not everything is as clear cut as the upper management believe it should be. We should challenge stupidity in nursing, we have patients lives at our fingertips and if we don't challenge and stand up for what is right , then we are not only letting down our patients but we let down ourselves. Where is the passion in nursing? Are we so down trodden these days that enthusiasm and passion is no longer recognized? Of course everything is blamed on money, or Obama! Really we blame Obama he has the worst job in the world and everything is blamed on Obama care, it does not matter one iota who is in power in our country, the real power is behind the scenes, we never see them but I guarantee that the insurance companies in this country have a huge say! We can make a difference in nursing, instead of moaning and complaining about how hard we have to work, we should focus on what we can change and not what we can't. Nursing historically has always been a hard job, with long strange unsociable working hours, if you read old threads from the beginning of allnurses.com you will see bemoaning of short staff and long hours and nasty managers. Plus Nursing was very poorly paid and it has only been in recent years that pay has improved. How can we make a difference, embrace the challenges, enjoy the patients, teach the students/new RN's. Form relationships that can follow you through life, celebrate your successes, and learn from your mistakes. Mistakes happen, it is life; don't let them ruin your life or your career. Identify when a task is beyond your skill mix, ask for help and don't take no for an answer. Move on from a job if it is not the right one, we are always going have horrible days but they should be few and far between not the norm. If you are truly miserable in a job then it is going to reflect in your work and you will be more focused on how miserable you are rather than making sure your job performance is above average. Negative attitudes are contagious, stay away from the naysayers and try not to be one. Gossiping is another contagious behavior we see at work; try not to get involved it will only drag you down. I know this is easier said than done because we all love a good gossip, but unless you saw or heard it don't assume it is true. Have I always been able to do what I am advising, no I am human I do have a big mouth but I do try to practice what I preach. Have I always been happy in my job? No, but I have always gone about my work with a smile on my face. It is amazing what a smile can do, it is more contagious than the naysayers and gossip!
  8. VivaLasViejas

    You Can't Go Home Again

    It was just an ancient nursing home, with Vander lifts parked in the too-narrow hallways and the hustle and bustle of staff members on their way to answer the constant shrieks of tab alarms. Located on top of what must be the biggest ant hill this side of the Rockies, it was utilitarian and built for efficiency, not looks, although the powers that be kept trying to improve it by installing hardwood floors and elegant lighting systems in the hallways. I tried telling them once that it was pretty much like putting a Ferrari engine in a Honda, but of course that suggestion fell on deaf ears. I'd worked at Shady Acres for almost three years, however, and as happy as I was with the job I have now, I still missed the camaraderie between the staff members, residents, and even management of this place. This was a facility where you would see the DNS working the floor, the resident care manager passing meds, the administrator running out to buy Popsicles for everyone on a 100-degree day, the dietary manager helping to pass trays in the dining room. In other words, the teamwork was the best I've seen anywhere, and I'd figured on staying there for the rest of my career. Alas, fate intervened in the form of a floor career-ending injury to my left knee which required surgery. At the same time, a new company had taken over, staff cuts had begun, and I noticed the fact that most of the available hours were going to younger, faster nurses. By the time I was finally laid off, my confidence was shot and I was faced with being unemployed in an economy that was not at all kind to the over-50 crowd. Still, I never blamed the facility for my misfortune. Management had been good to me up until the day they let me go, and my co-workers were the best ever......so I made the promise to visit as soon as I got settled in at a new job and update everyone on where I'd landed. In the meantime, we kept up through Facebook and bumped into one another in town on occasion, and for a long time it was enough. But the idea of visiting my old 'home away from home' stayed with me. Out of all the places I've worked in my career, Shady Acres was the one where I'd truly felt at home, and a part of me still yearned to be part of the team again despite my contentment with my current job. So why was I so hesitant to actually go there?? Last Wednesday, I found out. I figured there was no better time to do what I'd been promising my friends for months and months, and stopped in after a doctor's appointment. I'd lost weight, had my hair colored and styled, and was in high spirits thanks to a new medication that had kicked the last of my winter depression to the curb. I pulled into the employee parking lot and went in through the back door, just as I had in the old days; of course, I was spotted almost immediately, and it seemed as if the next hour was spent being hugged and squeezed. Yes, the gang had missed me. Several of them asked when I was coming back; others were curious about my "new" position (I've been there 2 1/2 years) and wanted to know what I did and where I was doing it. Almost to a person, they were complimentary about my appearance and demeanor, noting that they'd never seen me as happy as I seemed to be at that moment. Yet something was very, very different. The place, the people, the residents all looked pretty much the same as when I'd left them......it was I who had moved on. As much as I'd missed this old nursing home, as much as I'd wished I could work with this splendid team again, I didn't belong here any more. I hadn't known it then, but when those doors had shut behind me back in summer of 2010, they'd closed forever.....I was now firmly ensconced and comfortable in my nurse/administrator position, and even if I hadn't been, I was no longer part of Shady Acres. Of course, all these folks are my friends and will always be, and doubtless I'll stop in again for some chatter, a few hugs, a laugh or two. But as my parents' generation used to say, "you can't go home again"......and the place I once called my home away from home, wlll never be home to me again. And that's OK. 🙂
  9. saramoss04

    My Most Memorable Patient - Geraldine

    Patients create a lasting memory for numerous reasons. There are the very critical patients who may not have a positive outcome but you know you learned some valuable lessons from; there are the funny patients who always make you laugh either appropriately or inappropriately; there are the really gross patients whom you can only talk about with fellow co-workers (because normal people would not be able to handle it); and there are the patients who you just want to take home with you as a mother, father, sister, brother, or grandparent. Geraldine falls into the last group of patients - someone you just want to take home with you. Geraldine was a patient on our floor, one of whom I had the pleasure of caring for one day. She was a pleasant 94-year-old woman who was content to read the paper and sip on her morning coffee. As I came in to do vital signs she put down the paper and we began to chat. She then said to me in the sweetest Boston accent, "Lawbster - I just love lawbster! Look at this restaurant (pointing to add in the paper for Bone Fish Grill) have you ever been here...they have lawbster!" I told her yes I had been there and it was really delicious. After some additional small talk about how much she loved seafood she asked if I would like to go to that restaurant with her one day. She was just the sweetest elderly woman I had ever met and I just instantly loved her! I said I would love to and she then proceeded to write down her phone number and address. Not much time had passed into the day and she was to be discharged. I learned that she drove herself to the hospital (yes she still drives and lives alone) but her son did not want her to drive home that day. We set up transportation for her and as I stood waiting for her at the front desk, she came walking down the hall, all five feet of her, dressed in her clothes with her purse around her arm ready to go. I am not sure why but I will always remember that moment and how cute she looked. Fast-forward a few weeks - maybe even a month or two and as I was cleaning out my workbag I found the note with Geraldine's phone number and address. I thought to myself, "Oh what the heck I will give her a call." So I called and Geraldine remembered me and exclaimed how much she was hoping that I would call. She said she told everyone about me and when she was in the hospital another time with her son she tried to call different units to see if I was working so she could come and see me (she couldn't remember which unit I worked on). We made plans to go to Bone Fish Grill and from that point on became very close friends. For the next few months, Geraldine and I would have our dates. We would chat on the phone about once a week and we would go out and do different things, we went to Panera Bread; we went and had Tea one afternoon at an English Tea Shoppe complete with scones and small cucumber sandwiches; we went shopping together; and she even made a spaghetti dinner at her house complete with salad, bread, and dessert. Geraldine introduced me to all of her friends and even her son that lived in the same building. She was like my grandmother and we were friends. One day I called Geraldine and she told me that her son, who was ill and in and out of the hospital very frequently, had passed away. She was so sad to have lost her son and to add to the grief and pain her other son, who lived up north, was coming down to get her to take her back to live with him and other family. Her son that passed was the only family that lived in Florida and now that he was gone, her son was moving her up closer to family. She was devastated to leave the place she had known for more than thirty years. As she continued to tell me the story she cried and I found myself sad and crying as well. She was my friend and we always had fun together and now she had to leave. Not only did she have to leave but also she was doing so against her will and just after her son passed away. I asked her when she had to leave and she told me she was leaving on a plane in two days. I promised Geraldine that I would come over right after work the next day to say goodbye. The goodbye was sad. Not only for losing my friend but also for seeing how sad and upset she was about the whole thing. I met her son, the one moving her up north, and he pulled me aside and said thank you for being such a good friend to her. He said that she talked about me all the time and how much she looked forward to the times we would talk and go on outings. It meant a lot to her and her whole family. The way he made it sound was as though I was doing a job - I tried to explain that I really loved being with her and I was sad she had to leave. Her house was all in boxes and she sat on the couch as her son sold her car (no more driving) and packed a suitcase. The house that she had always kept so clean and organized and decorated sat in boxes. After about two hours I said my last goodbye and went home. She left on the plane the next day. Geraldine has been up north for just about eight months. During this time she celebrated her 95th birthday and has moved into a new apartment that she says is so big she might just get lost. We still talk weekly and she tells me how much she hates the cold weather. When she asks how the weather is in Florida I don't have the heart to tell her it's now December and it is still 80 degrees (she loves the hot weather). She constantly asked if my boyfriend had proposed to me yet, and if he hadn't she was going to have to have a word with him (he did and she was over the moon happy). She has taken pictures of her apartment and sent them and I sent her pictures of my new home, she always asks how the house is coming along. And just this past week I told her I was planning to come visit her this spring and she could not believe it she was so happy she almost cried. Every conversation she tells me she loves me and misses me and I tell her the same. She is my little Geraldine. There are so many other stories and little things that make Geraldine the most memorable patient/person I have ever known. Just as much as I am told that I make her day when we talk and do things, she makes mine as well. I miss her dearly but am happy to be able to talk with her and to be able to make a trip to see her. Anyone who knows me knows about Geraldine and that to me makes her my most memorable patient.
  10. canesdukegirl

    Silver Lining

    I stare at the four LED panels in front of me, each displaying cases for every OR, listed by room. I groan inwardly, bracing myself for a busy day. "Canes, you ready?" asks the Medical Director. Every morning, the Medical Director and the Anesthesia Coordinator and I meet to discuss add on cases, and the movement of scheduled cases to ensure the completion of the day's schedule. We collaborate on which cases to move, which order add on cases should go, and discuss any unusual circumstances, such as time constraints for surgeons, specialty staff availability for difficult cases, and special requests. Today is conference day, which means that surgical staff and anesthesia staff meet for the first hour of the morning prior to starting cases. Because I am the charge nurse, I can't attend the surgical staff meeting. Someone has to man the ship, right? "Ok then, Canes. I'm off to conference. Page me if you need anything," the anesthesia coordinator sings over her shoulder as her wooden clogs click on the tile floor. I glance up to acknowledge her, but only see the tail of her white coat as she throws it around her shoulders like a cape. Ahhh...a few minutes of peace. I can get so much done now! No sooner had I turned my back to the glaring LED panels than a resident appears out of nowhere, tugging on the sleeve of my lab coat. "How's your day going?" she asks, traces of a smile dancing on her lips. She blinks rapidly and raises her eyebrows. "Depends on what you are holding in your hand," I reply. There is no smile dancing on my lips. She sighs. "Sorry to be the bearer of bad news, but I have a 65 year old woman in the ED with an incarcerated hernia. We need to get her to the OR now." I glance at the LED panel and search for the trauma room. Several cases had already been posted. Her gaze follows mine, and she reads the board with me. As if she could hear my thoughts, she turned to me and said, "It can't wait. We have to go right now. We will bump ourselves." "Of course," I reply. "I'll page Dr. Thomas and let her know that we need to open the room right now." "Thanks, Canes," she said. "I'll go ahead and bring her to the holding area, ok?" "Yep, that's fine," I reply. Running my finger down the list of staff for each room, I found the staff assigned to that room. Today, conferences were broken up by committee teams, and I didn't know which committee the staff members were on. I paged each manager, asking if Nurse X and Nurse Y were on their committee, because I needed them to start an emergency case. "Hey Canes. Nope, Nurse X isn't on my committee." "Canes, I don't have Nurse Y with me." "An emergency already? Sorry, Canes. Nurse X isn't here." My anxiety started to mount. My options were becoming more and more scant. When the phone rang, I jerked the receiver up. "Canes, I have Nurse X with me. But she's in a meeting," the manager says. "Yes, I know that. An emergency case was just posted, and I need her to start the case," I said. "But she's in a MEETING. She's the recorder for the meeting. Can't you find someone else?" I am incredulous with this response. "Last time I checked, patient care trumped committee meetings," I reply, with barely contained sarcas Nurse X checks in with me, and I fill her in on the details of the case. She is a trauma fiend, and loves the fast paced environment of a good trauma case. "Did you find Nurse Y?" she asks. "I still can't locate her," I said. I paged Nurse Y's manager again. Ten minutes later, the manager calls me. "We're in a meeting, Canes. What's up?" she said with a clipped tone. "I have an emergency case, and I need Nurse Y. Nurse X is already preparing the room," I said. "Oh. Nurse Y isn't scheduled to work today," she said in a matter-of-fact way. "But you listed her in the trauma room," I said. "My mistake. Sorry about that," she said, and hung up. "Canes, our patient is in holding. Can we roll back now?" the resident asks me. "Not quite yet. I'm still looking for another staff member," I said. Luckily, one of the committee meetings broke early, and staff were milling around the desk looking for their assignments. "What's with the frown?" one of the staff asks me. I explain my dilemma, and bless her soul; she volunteers to start the case. One fire put out. As the morning progresses, I find that I am without a secretary. The phones are ringing off the hook. I page my manager. "You rang?" she said. "Did you give our secretary the day off?" I asked. "Oh, yeah. I meant to tell you that. She had to attend her son's graduation this morning," she said. "Did you have a replacement for her?" I asked, my voice reedy. "Well, originally I had planned to come to the desk to answer phones for you, but I forgot that I have back to back meetings and won't be available until two. Do you need help?" Softly, I close my eyes. What was I supposed to say? That she couldn't attend her meetings because she had to play secretary for me? "It's ok. I can get through it," I said, eyes still closed. The next few hours felt like a war zone. As I was assigning lunch reliefs, I posted one emergency case after another, took care of students/observers/reps asking for scrubs, contacted surgeons for availability for cases that could be moved up due to cancellations, kept Dr. Thomas in the loop with every change, handled a registration problem, fixed a computer interface problem, contacted staff/sterile supply/managers to room changes, changed staff in 3 different rooms to ensure competent matches for cases, and guided med students to rooms...the phone would NOT stop ringing. A surgical attending was arguing with me about his case placement, and I couldn't get a word in edgewise. I let the phone continue to ring, adamant that I would get my point across to the surgeon. Looking down at the phone with his face creased into an angry frown, the surgeon said, "You gonna get that?" Seething, I picked up the phone. "OR, this is Canes." "Uh, somebody called me from this number." "I'm sorry, what did you say your name was?" I asked, trying to keep the irritation out of my voice. "Dean. Somebody called me from this number," he said again. "Hey, Dean. Are you a patient?" Somewhere in the cobwebs of my mind, the name 'Dean' stuck out. "Yeah. I was there last month. Somebody called me. I just hit *69. Who called me?" We have about 500 staff members in the surgical services department. Needless to say, I had no idea who called this patient. But he was a PATIENT. He deserved my undivided attention. "OK, Dean, let's you and I try to figure out who might have called you." The surgical attending slapped the counter in front of me in frustration. Two staff members were waiting to get their assignments. Three phone lines were ringing. The pre-op nurse was gesturing to me. An anesthesiologist was talking to me as if I wasn't on the phone. I spent twenty minutes on the phone with Dean, only to realize that he wasn't a surgical patient. He was a dialysis patient, and wanted to know when his next appointment was booked. I knew how frustrating it must have been for Dean to be transferred to one department after the next, and I wasn't going to transfer him again. I put him on hold as I contacted the dialysis unit, and got the information he wanted. As I relayed the information to Dean, his response caught me off guard. "Hey, thanks, lady. Ya' know, I think the call might have come from the transplant surgeon, Dr. A. He called me yesterday and said there might be a match for me, and that I should come to the ED. What do you think? Should I call him, or do you think I should go to the dialysis unit?" In spite of me, tears welled up in my eyes. I looked to my right and focused on the transplant information sheet tacked onto the corkboard. Sure enough, Dean's name and information were clearly written out. "Yes, Dean. I see that you are booked for a kidney transplant. Come on in to the ED. We'll see you in a couple of hours," I said. Gently, I replaced the receiver. I stepped away from the melee at the desk and gathered myself, encouraged that I would meet Dean personally, and help him through his life changing transplant surgery. I'm so glad I picked up the phone.
  11. Ruby Vee

    It's Already Gone On Long Enough

    My mother-in-law had a stroke last week. Details are sketchy -- she's several hundred miles away and the daughter who lives closest, a mammography technician, knows just enough to tantalize my husband and me with some of the medical details, but not enough for us to get the full picture. She had either a right CVA or a left -- Rosita isn't sure -- and has either left hemiparesis or left -- again, Rosita isn't clear. What is clear is that she had a diminished level of consciousness and wasn't able to swallow. Did we think she should give permission for a feeding tube? Mamita is 89 years old. She's been institutionalized with dementia for nine years. No matter what we do or don't do, she isn't going to get better, her dementia continues to progress, and she hates living in the nursing home. When she first went there, she wore an ankle monitor because she kept trying to leave. She was in the memory care unit because Hurricane Katrina and the disaster that was New Orleans snatched away what remained of her clarity and functionality, then the Sheriff's department put her on a commercial flight and sent her off to live with her daughter in New England. What else were they going to do with her? She couldn't be left alone because she'd immediately try to go back to her house -- under water at the time. And letting her wander among people wasn't safe -- she tended to attack anyone who annoyed her. Mamita was always easily annoyed. Nine years in a place she hated, and my first thought was that the stroke might offer her a way out. If you ask anyone whether they'd like to die with dignity, or whether they'd like to be kept alive on machines even if there's no hope of recovery, no one opts for the machines. At least, they don't if you give them some clear idea of what you're asking and ask them before they get to the point of being awake, afraid to die and facing the point where the only hope of keeping them alive IS the machines. Why, then, do we even offer the feeding tube to the family of an 89 year old patient institutionalized with dementia for nearly a decade and without any hope of recovering? I'm not sure how serious the stroke turned out to be -- she has hemiparesis. Even if there was a chance of recovering from the stroke, she won't recover from the dementia, and the dementia makes it all but impossible for her to recover from the stroke. How do you get her to do the exercises that will strengthen her, how do you teach her how to use a spoon or dress herself or use the toilet with one hand? The stroke took away, and the dementia makes it impossible to get it back. Mamita got the feeding tube. Her middle daughter, the one who lives farthest away and has always wanted the least to do with her insisted that she couldn't live the rest of her life knowing that "Mamma starved to death." Why is it always the ones who live farthest away, who have the least to do with the patient while they are able to interact and who know the least about the situation who always draw the line in the sand and insist upon "doing everything"? Why is it that they don't listen to the son who knows? This isn't "doing everything." It's just prolonging her death. It's already gone on long enough.
  12. dcwang


    Countdown until graduation! I still can't believe I'm writing that. One more month and I'll graduate with my BSN. I remember walking into my first class, health assessment with disbelief and shock at the fast-paced accelerated program. When I started nursing school, I never thought this day would come so fast or that this day would even come. The first month of nursing school went by so slowly and I couldn't see the end of the tunnel. I didn't have hope. When my fundamentals instructor would say "During the pinning ceremony", I did not think that it would actually happen. Every day, I went home crying telling myself that nursing school would be over, the pain that I felt was temporary and for the better future. I said to myself, "It's only 1 month and there are 14 more months to go!" These days, I shed joyful tears, not tears of sadness, and I feel a little more hopeful. Graduation day will be one of the happiest moments in my life. Nursing school is both an angel and a devil. Nursing school took away 15 months of my life and it took a huge toll physically, mentally, and emotionally. I feel exhausted, that I have aged ten years, but I think positively that post-graduation is the start of a wonderful time in my life. Recently, I looked at pictures from the first semester of clinical and to pictures of me now, I was more energetic when I first started nursing school. Without nursing school, I wouldn't have experienced the camaraderie with my study group. Little did I imagine how diverse my nursing school friends would be. We went through nursing school together and that is what makes our bond stronger. We understand each other. We will still connect and keep in touch after we graduate. We spent so much time together, my study group is like a second family to me. Thinking back to the first injection I gave, the first amputation I saw, and the name of the patient who passed away, I've realized how much I have grown. The most grisly wounds and amputations don't scare me anymore and I've come to an understanding that I can feel that sadness of death, but seeing it as a natural aspect of life. Through the stress of nursing school, I lost a relationship I knew that never could be, but it was a luck in disguise. I found a man who went through one of the toughest periods of my life with me. When I pass my NCLEX, I will have a fulfilling job that makes a difference for patients, whether it is helping patients heal emotionally or physically, or achieving their wishes in the last few months of their lives. This is what makes nursing school worth it and gives me strength as I move forward in my nursing career and life. I'm glad I read what nursing school was like, or else it would have been a bigger shock to me. My biggest advice as a fourth semester nursing student. Enjoy life and have fun for a bit before you let nursing school take over your life. You will love and hate nursing school. Because of nursing school, I have matured throughout these 15 months, but there is so much more to learn as a new graduate nurse. In the future, I will look back at nursing school with both feelings of sadness and joy- what I lost that couldn't come back and a more mature person I have become. I never want to go through nursing school again, but I am tougher, stronger, and more compassionate because I went through nursing school.
  13. Lindsey McGraw

    Quest For Girls

    a great opportunity for an internship to become an OR nurse had been offered to me, but after this diagnosis, everything was put on hold. A disease that affects 1 in 8 with today's statistics, is a very scary thing. This article is to "lighten the subject" with my story of my quest for new "girls" after surviving 17 years. Since I have the tenacity of longshore men and a sense of humor, there was no doubt like every other challenge in my life I would turn it into an adventure. Deep down inside I was always shy, putting on a good front for all to see, but an internal emptiness prevailed. Life brings us messages in many forms ie; dreams, visions, or in my case a new good friend Jackie... a pretty blonde with big blue eyes and a nice smile. Sharing with her my dilemma of never having had reconstruction all these years, which was why on occasion I was so shy around the opposite sex, she gladly shared with me that her "girls" were bought and paid for. An added factor that I had lost a husband who could not cope with the situation, so this made it doubly hard to trust anyone of the male gender, let alone date. Almost instantaneously it dawned on me that man-made saline implants were definitely an option for me to make me whole once again. A little slogan ran through my mind "What Mother Nature did not give you saline can fix you." My situation was not a case of just wanting to be enhanced, but one of being whole again, and it a big problem purchasing clothing anymore. With the new sexy looks, "girls" abound. With a limited wardrobe of big shirts, sweatshirts, and tank tops with a shirt to cover my vacant right side, I was anything but fashionable. Determined to not share my secret with anyone yet, I discreetly set up my first appointment which allowed me to stay in my safety zone. Only after I had made a phone call and set up my consultation appointment with a local plastic surgeon, did I tell my best friend? She was shocked, speechless at first, but agreed to accompany me for moral support. The day of my appointment arrived, and LaVern and I drove to the next town where the clinic was located. Sitting in the parking lot of the office building, she made me promise to behave, and not embarrass any of the staff members with my off-handed comments known to come out of my mouth with little notice. Again this was a facade to hide my underlying feelings of insecurity. Once inside the clinic, I patiently waited for my name to be called, and became very nervous with anticipation of what the surgeon would tell me about my options, since I had a grueling surgery back in 1991 of a modified radical mastectomy leaving my arm swollen, (suffering from periodic lymphedema) and whole right side deformed. Even with the subtle floral pictures on the wall, my anxious feelings were not at all relieved. A soft knock on the door, and in walked a young, dark-haired, handsome doctor with kind eyes. He must have sensed my apprehension because was quick to try to put me at ease with some idle chit-chat about careers etc. After he examined me I was delighted when he told me that I was a candidate for an implant, skin expander, that each week a small amount of saline would be added until I reached the desired size to match my remaining girl and to make me whole again. Walking out to the desk after my appointment, he approached me at the desk, placed his arm around me, stated: "it will be just fine." No doubt I was very visibly shaken by this experience and exhilarated at the same time. As I left that day, a flood of varying emotions came over me. Instantly when I reached my truck, a flurry of phone calls was made to some of my other best friends with an update that I was indeed having this reconstruction surgery to make me whole again in while at the same time having episodes of laughter, and crying. A whirlwind of activity followed that day with a scheduled surgery date in the next ten days. I managed to do all of the pre-op requirements, and a final appointment with my doctor to answer any further questions my date was set. Showing up at the hospital for my surgery, I had no idea how scared, apprehensive, and mixed my emotions would be. Everything went well, with being able to return home in a matter of a few hours for my recuperation time of two weeks. In a matter of days I began to feel wonderful, exhilarated, and when looking in the mirror seeing a little " perky girl" where a gaping cavern had been for years gave me a real sense of "Whoo Hoo!" A wonderful and exhilarating feeling that is very hard to describe or put into words. Each week I return to my surgeon to have my implant/skin expander enlarged with a shot of saline to slowly match my good side. Looking in the mirror I have to laugh, because now I have the saggy, perky puppet show going on...because my new implant is high/tight, and of course gravity has set in on my other side. When I have my final phase everything will match up giving me a nice look. My first shopping trip to buy new clothes and the Maidenform store to purchase new bra's found me almost in a state of panic, because no longer am I limited.....bring on the cleavage, world. This story of my personal experience in no way should influence how a woman chooses to handle her own situation of having reconstruction or opting to not have this procedure done. Personally, I will forever remain empathetic for anyone who is suffering from, fighting with, or that has conquered this dreadful disease. It is a woman's own mindset, and an example of how one woman handled her mastectomy issue was to go out and buy a Harley motorcycle, driving off into the sunset. Ladies it is never too late to experience all life can bring you at any age. So, follow your heart and dreams, living life to the fullest. With a time frame of approximately six weeks, I patiently await my final surgery where I will receive my new "perky, pretty girls" with a totally new outlook on life.
  14. ElizabethStoneRN

    The Gifts of Nursing

    It is better to give then to receive...those classic words of wisdom ring especially true for those who chose nursing as their profession. Many of the "gifts" of nursing, for me, have actually been moments in time, memories about patients and feelings about certain experiences with them which help remind me why I became a nurse. Others are related to the nursing profession in general- those perks that we all can appreciate. The following are some of the gifts from my career as a pediatric emergency nurse: 1) The adrenaline rush that comes from working with my peers to intervene quickly to help save a critically ill child; the thrill of succeeding. 2) The instant gratification that comes from seeing so many ill and injured children feel better within hours because children are SO resilient. 3) The satisfaction that comes from helping to collect evidence towards the prosecution of sexual offenders and child abusers- and from helping to remove the children from those situations. 4) The laughs that come from impromptu conversations with patients and their families- the happiness I feel from knowing that they feel comfortable enough to have these conversations with me. 5) Educating many parents about how to care for their ill or injured child at home and empowering them to do so. 6) Earning the trust of young children who have been injured and are brought in as pediatric traumas; the sense of accomplishment that comes from being able to reassure them by simply looking into their eyes, holding their hand, and speaking to them gently in terms that they understand. 7) Collaborating with other members of the healthcare team to support bedside presence during multiple codes and at the end of life; helping to advocate for this and facilitate it. Seeing the sense of closure that this brings to families. 😎 Helping to keep a young child alive until her mother could arrive to hold her during her last moments on earth. 9) Giving a newborn baby who was abandoned in a restaurant's bathroom his first bottle, and holding him for several hours after my shift was over. Witnessing the goodness of others who came in to pray for him. Seeing him again later that year with his new family, as a happy and healthy 6-month old. 10) The inspiration from witnessing the strength and love of a family who is losing their young child to cancer yet still is able to experience joy and humor together- learning through them that death is a part of life, even when it happens much too early. 11) The simple joy that comes from being able to hold babies and converse with young children on a regular basis. 12) The flexibility of my schedule- the fact that with every major phase of my working life- from young adulthood, to parenthood, I have had the opportunity to alter my work schedule to meet my family's needs because nursing is a 24/7 profession! 13) The endless options of the nursing profession...I can think of no other career which offers so many options, from clinical practice to research, writing, teaching and consulting. 14) The learning that never ends. There will never be a point at which I know everything there is to know as a nurse, and that's how I like it. I see something interesting and learn something new every week. 15) The sense of pride I feel from being part of a healthcare team which works together to do amazing things for our patients- from helping to heal them, to alleviating their suffering, to advocating for them so that they are safe at home. Being a small part of this is both an honor and a privilege. These gifts remind me that despite all of the giving that nurses do on a regular basis, what we receive in return is far greater. This, to me, is the greatest gift of nursing. Please share some of your gifts as well!
  15. homenow09

    A Time to Reflect

    I have been a nurse since 1973. Nursing wasn't something I had in mind for myself when I graduated from high school. In fact, I was totally undecided what I wanted to do with my life until a close childhood friend of mine suggested I enroll in a Practical Nurse Program she was interested in. Nursing School was hard to get into in the 1970s. You put your name on the waiting list and wished for the best. Before you knew it, September arrived and I had gotten my books, uniform, and financial aid all taken care of. I was ready to start! Nursing School definitely had its trials and tribulations, but that twelve month program flew by fast. On graduation day, my parents were so proud, their little girl was a Nurse! Shortly after graduation, I landed my first job in a Surgical Intensive Care Unit. I received fantastic on the job training there. Nothing in my short 18 years of my life ever prepared me for what was to come! Sure, I knew it meant I would be taking vital signs, bathing, and feeding patients. I will never forget the first patient assignment I had. A young man devastated by a motorcycle accident, laying in a coma, head injury, broken bones, on a ventilator. Six months later, that same young man actually walked into the SICU and wanted to meet the nurses who cared for him. Unbelievable experience! After enduring a few life changing events in my life, the time was right for me to further my career and return to Nursing School to become a Registered Nurse. That meant living life in the fast lane, work, eat, study, study, study! I remember my Nursing instructor telling me you must have empathy to be a nurse. I've always tried to put my self in my patient's position. How would I feel if the person in the bed was my Mom or Dad? Nurses need to be advocates for their patients. I can remember being that advocate many times in my career. A patient once told me about her hospital stay experience and it actually evolved around the nurse who took care of her. Sure her doctor played a part in her care, dietary provided her meals, and the Nursing Assistant helped her nurse give care, but the Nurse is who she remembered the most! I never realized how much of an impact the Nurse made on a patient. Patients look to their Nurse for guidance and reassurance. Someone they can trust. What big white shoes to fill! I've worked as a nursing assistant, Practical Nurse, and Registered Nurse. I have worked in a Nursing Home, Doctor's office, and in a hospital. I've even worked as a substitute School Nurse. I tried it all! I worked daylight, evenings, and yes, the dreaded night shift. As I write this article and reflect back on my own experiences as a nurse, I look at my daughter who aspires to become a nurse just like me. I want to think that I made a difference not only in my daughter's life, but also in all the lives I touched as a nurse. As I wind down on my career, I can look back and know that I served my profession well.
  16. savoytruffle

    On digging deep and carrying on

    I have battle going on inside my head. Two conflicting ideas engaged in a tug-of-war that has left me feeling depleted and angry and just...tired. You see, I am a nurse. I went into nursing because I love science and I love the human body and all its mysteries and miracles. I also believe that caring for the sick, the elderly, and the disadvantaged is a noble and rewarding thing to do. It makes me feel important and needed. It speaks to the Humanist in me. Lately, I don't want to be a nurse anymore. I want to throw my hands in the air and yell obscenities at the top of my lungs. I also want to crawl under my desk and take a nap. Neither impulse wins, so here I stay in limbo neither fighting nor fleeing; merely existing in my ennui. I take complaints from angry family members sometimes. I listen as they vent their guilt and frustrations. I calmly apologize and explain the disease process taking hold of their loved one and assure them that feeling the way they do is okay. Sometimes, they are unwilling, or unable to listen. They don't want to understand; they just want someone to blame; someone to be angry at. That usually ends up being me, as I would rather take the brunt of their anger than have them rage at my staff. I try to protect my nurses from that vitriol so they can continue to feel good about what they do. I tell my nurses how important their work is, and how it matters to me and to the people we serve. I internalize all that pain and anger and swallow it. Sometimes I come home and chase it down with rum. And cookies. I stay because I am needed and I like the work I am doing. But I am so freaking exhausted. So tired. This constant caring, this extreme level of giving a crap; it takes a toll. I am used up to the point that I don't care as much as I should. I have issues that need to be addressed at work. I have work to do! I am the leader. I need to take the reins and steer this mad horse onto the safe path before it careens over the cliff of failing standards and poor patient outcomes. I should want to do that. I should care so deeply that I defend and fight for my nurses and my residents and my job, but instead, I just want to say "eh" and walk away. I've carried on for so long that I simply cannot any longer. That's the thing about nurse leaders, we feel we need to do it all ourselves. We forget to call on our supports, our colleagues, our resources. We forge onward alone, carrying the crushing weight of responsibility squarely on our own shoulders, holding our heads high and being strong for everyone else. And we wonder why there is such a high turnover rate; why nurses job hop from one type of nursing to another. As nurses, we have made ourselves clean exit strategies into new learning experiences and new environments in an effort to stave off the burnout. We discuss how rotating to a new department and learning a new skill re-invigorates us and keeps us passionate for the work we do. But what about the nurse executives? We at the top have fewer options. The higher up the leadership ranks we get, the fewer spots on the revolving job carousel there are to keep up the novelty and stave off the burnout. That is where I am finding myself tonight; cruising the job sites, looking for the new shiny distraction to keep me from realizing how awful I really feel about nursing. I've been searching postings to try and locate that "golden opportunity" that will make me fall back in love with my chosen career field, instead of leaving me wishing I had become a dog groomer at the end of the day. This is the hard, cold realization that I have come to tonight: IT DOESN'T EXIST. There is no perfect job in the perfect five star or magnate facility with a five minute commute and happy, engaged coworkers who all seem to "get" me. A chorus of cherubs will not sing me through the doors of a new facility, waving roses and handing me a perfect department of health survey. Healthcare is a minefield. You never know what might blow up in your face or when, but I promise you, something always will. The only thing I can control in this is my own ability to pick up the pieces and keep slogging through. I don't mean that to sound bleak, and I know this is probably the worst pep-talk ever given. I'm really only trying to psych myself up, anyway. What you do with my rambling is your own decision. Tonight my exhaustion is channeled into anger. I don't want to move on. I don't want to start over. I want to stay where I am and continue to carry on; and I want to build up my 401K darn it! So instead, I am going to try to find that golden egg called "work-life balance". I DON'T KNOW HOW TO DO THAT. I've never been so tired, but I've also never been so determined to stand my ground and say "this is worth it". The changes I want make at my facility are big and I am going up against a corporate culture that expects directors to "live to work". Last year I took 3 vacation days. THREE. If I can hang on another year, I will have earned 3 weeks. My family really deserves that. I deserve that. I just have to keep calm and nurse on a bit longer. Oh, and get some malpractice insurance. I should also lay off the cookies, call up a friend, and get a massage. I've got to start caring about myself so I can care for everyone else.
  17. VivaLasViejas

    Nine Lives

    I swear, my nursing career must have more lives than a cat. I knew it was over when I had a nervous breakdown and walked away from the hospital I'd worked in, off and on, for five years. I knew it was over when I aggravated an old knee injury and had to have surgery that (supposedly) ended my floor-nursing days. I was REALLY sure it was over when another meltdown cost me my 'dream' job. And then, two months ago when I realized I no longer had the cognitive ability to continue in an active nursing role, I became absolutely, positively certain that my career was dead in the water. Now......not so much. It turns out that there is something left of the nurse I once was; again, I seem to have found redemption in the same old nursing home that I've loved ever since I took my CNA training there twenty years ago. All I do is weekend admissions, a little QA work, and the occasional med pass (see The Stumblebutt Chronicles for a glimpse of my efficiency at that particular task), but it fills a need for both the facility and my identity as a nurse. I never realized how important that was to me until I was faced with the prospect of leaving nursing entirely. I still might have to---I'm pretty limited in what I can handle---but I've decided I'm going to give it one more shot, and as long as my facility supports me in that, I'm not going anywhere. A major factor in this decision was, of course, not having the foggiest idea of what kind of work I'd want to do instead. I used to think that my biggest problem with nursing was in having to deal with the public all day long---if I could simply work uninterrupted for part of the day and have somebody keep patients' families out of my face, I'd have been a whiz at it. But I could be working at Safeway and still have to buy into that "customer service" mindset, only I'd be doing it for minimum wage instead of....well, what I make at my current job. So obviously there's no advantage in leaving nursing for retail. I also wondered about transferable skills. Despite my difficulties with concentration and multi-tasking, I'm pretty decent at computer work, and I thought about taking an office job of some sort, maybe even in a medical clinic. But again, there was the issue of being around other people all the time, and the constant ringing of the phones would have made me certifiable by the end of the first day. Scratch that off the list. Long story short, I simply couldn't come up with ANYTHING that was better than what I'm doing right now. Sometimes I wish it could be a little more exciting, but then I remember what "excitement" does to my disposition and my ability to focus, and I thank Heaven for the relatively low stress of my job. Sometimes I also wish I could just stay home and earn a living by writing about nursing, but then if I weren't practicing even in this minor capacity, I'd soon run out of ideas and have to go back to work for real. Besides, my head doctor has this funny idea that I'd isolate myself at home and miss out on normal human interactions, and for some reason he thinks that would be a bad thing. Go figure. So....I am still a nurse, and a nurse I shall remain for the time being. It's too much a part of me. I may not be able to do what I once thought of as the 'toughest job I've ever loved', but I can still contribute in my own small way. After all---as corny as it sounds---there's nothing quite like the satisfaction of having a patient or co-worker say "Thank you!" and knowing that at least for today, I made a difference. Guess you could say nursing's got its claws into me and won't let go. Meow.
  18. Ginger's Mom

    Never Assume

    At work, I was participating in an accreditation survey. This is a nerve-wracking experience where a seasoned surgeon spends the day reviewing the program. My colleague received notification that the surgeon was coming from Puerto Rico, her reaction was "this is terrible he will not know the details of the program since he's not "American". I pointed out that a Puerto Rican is an American and after looking at his resume that he was surgeon within the VA System. Initial communications with this doctor where tension-filled. He mispronounced everyone's name, he demanded items instead of asking and some of the requests were unreasonable. The days before the survey was filled with anxiety and dread. The day of the survey quickly came. Initially, I thought, he was our worst nightmare, his answers were short and terse. He would not start the survey until the VP (who was stuck in traffic) was in the conference room. Worse the Surgeon in Charge of our program was a woman and tension was so thick we could have cut the tension with a knife. I could not help by thinking why did we get stuck with this surgeon and it was going to be a very long day and would we pass the survey? The survey finally started when the VP arrived. The surveyor's opening sentence was that he had reviewed our application and that he commended the manager of the program. His issue was that she was overworked. He said he had to perform her duties in Puerto Rico due to the language barrier and she was overworked. This was great news since she did need help (and had pleaded for help on deaf ears) now she has two people assisting her thanks to this surgeon. He put our application on the overhead projector, he said he was going to make changes (our self-assessment). He went through the application line by line, in every case he changed our rating, but in our favor! He made wonderful suggestions to the program which has enrich the care to our patients. At the end of the day, he departed, the committee felt foolish we all made assumptions this would be a horrible day due to the ethnicity of this surgeon. We did great, we learned how to improve the program and score high on re-accreditation. I especially felt foolish since this is one of my pet peeves.
  19. CheesePotato

    A Hand in the Dark

    It was there. Just there. But I still could not reach. Humidity laden air choked with the smell of smoldering grass, prickled razor sharp from the relentless Summer drought, dimly aware of the sounds of a woman sobbing some distance away, the dampened moans of a wounded man, the haunting stillness of a hurt woman, incessant chatter of others not injured but no action. Not enough action. Pain. Blood. Through a haze wondering if it would be wise to be worried but dismissing it in the same breath as each victim is analyzed, checked, dismissed, catalogued: dislocated open ankle fracture, mild head injury with good pupil and neuro checks, broken fingers, terrified tears. Grateful for the pair of gloves keeping residence in the glove compartment of my sedan, ever stable, ever the same, parked carefully on the side of the roaring expressway saturated with life teeming along with the same intensity as the stinging sweat pooling down my brow. Some try to help. Some stop. Most drive on, content with a glance, perhaps a stare, a phone call. The most disconcerting are the ones that pause a little too long, phones held a little too steady, memorializing the moment as a photo op, a "hey look what I saw on my way to work" brag to post on some blog, some chat site, some socialization network. They single handedly rob the moment of what it is. They have no right. None. Stop. Focus. Pick the splinter of windshield glass from its place nestled in my grimy forearm. Not quite sure how it got there. Perhaps when I was checking around the vehicle, or rather, what remained of it where it lie on its side, crumpled, a seemingly discarded giant child's plaything tumbled to rest on a berm. I know better than to get near the vehicle. Trained as an emergency responder back when I was still cutting teeth of adulthood, I know the rule of thumb: individual safety first. Secure the scene, then the victims. But there is magnetism. A draw. A pull. A whisper in the part of me, the same part of me that guided my car to the shoulder, that guided me out, that made me stop. The crunch of needle grass beneath denim clad knees, for once glad of the jeans in the heat, grateful for the protection from the debris. Vision obscured by toppled, crunched car seats, tattered remnants of interior, depressed metal, caved plastic, it's peering into a cave in the broad daylight, hoping to see the treasure in the far alcove. Praying to see nothing. Finding your worst nightmare. A hand. Just there. A hand. Intact. Pale. Unmoving. Calling for attention, for hands, for eyes and knowing the sharp wail from the now pacing woman is that of realization and recognition. One is missing. No one noticed in the chaos. A momentary reflection on life mimicking slight of hand or a street magician's shell game. Stop. Focus. Sliding forward on belly and chest, arm outstretched, oblivious, in hindsight, not thinking. Pulled by some tether, some gossamer thread older than any study of medicine, the raw feeling of humanity seeking to aid another of its own. Reaching. Aware every movement could spell disaster--could end in a loss of precious balance and topple several tons of suffocating metal, melting rubber and steaming plastic. Unable to stop. Unable to succeed. The whimpering of sirens turns to a wailing shriek. More people. More chatter. Pulled away but still reaching with blind determination. Protests are noted but dismissed. Vaguely hearing the words fire, drought, gas leak. Forced to move away. Forced to abandon. Forced to let a life fade to potentially save my own, forced to allow a last breath to be drawn in terror, alone, wrapped in demolished hell, heat, noise. Unable to reassure. Unable to be reassured that it was already too late. Praying it was quick, instant, painless. Abandoned. A hand. Just there. A hand I will never reach.
  20. SICUshortCait

    What Happens When We Leave Our Dream Job?

    What happens when we have to find a new dream? When we came to a fork in the road; chose our path; ran towards our destiny and hit a dead end? Nursing is career of passion and a commitment not only to ourselves but to those future faces waiting with a name and date of birth. We sample different floors and hospitals throughout our education and excitedly tell each other stories of what we saw that day. We may have started school with a specialty we're sure of, but then it happens. We have that day; our day; our epiphany moment where we choose our path. Maybe it happens during clinical, maybe it happens long after we've been at the first job we're offered. There is that moment where those are OUR patients and that is OUR specialty. For me I was on a trauma unit for school; a far cry from the pediatric oncology unit I thought I would be on when I applied to school. My patient had crashed his motorcycle, had an MI, and a K+ of 6.8. We were bandaging his road rash while ortho discussed his broken bones and then we whisked him off to dialysis. I walked out of this step down and with wide eyes asked my instructor where these patients went when they were sicker. From that moment on I was on the fast track to SICU. Those were my patients. That was my unit. Fast forward 8 months to multiple knee surgeries and a fleeting return to work where I couldn't lift "My patients". I couldn't handle "My unit". Obviously I could have been in far worse shape, but that wasn't the issue at hand. Where do we go from there? How do we start over when we were so sure of what we loved? I talked to a friend recently who was leaving her dream unit and felt an enormous sense of fear and dread. There is a guilt we feel when we switch our path. That sense that we're giving up; abandoning the patients we once called "ours". In the days that followed leaving behind my dream I talked to friends and coworkers and scoured the internet looking for my new passion. Repeatedly I was told to go to the NICU. " The patients are lighter and the cribs are higher" I was told time and again. I dug in my heels, because as trauma nurses we don't do cute and cuddly. There was a sense that I was turning my back on my people by even seeming interested in the idea. I spent weeks toying with jobs that I had no passion for, but would allow me to sit. Something I didn't enjoy, but would provide me the time to go to school while I figured it out; anything but working with babies. Out of loyalty to my hospital I finally went upstairs to tour the NICU. I walked around arms crossed looking on respectfully. The first baby I saw was only 23 weeks old. As we continued to make the loop I saw hopeful parents sitting, waiting for news of an ounce gained. By the time I walked to the last decorated door, I was filled with questions for the nurse and a secret I was keeping from myself. A secret, that I may just be fully confessing now. I loved it. My head was spinning when I left. How could I love this unit? This was the unit I had shy'd away from since I started school. Babies? Babies. I thought it would never be me. I was afraid to even hold them and yet there I was. And that's when it hit me. I am a nurse. We are not our units. We are not our specialties. We may love them dearly, and we may thrive in one environment over another, but we are nurses first and foremost. We see people in distress, no matter how small, and we want to help. We want to fix the situation, and we want to learn. We accept the challenge and charge ahead. Our abilities are not limited to what we already know, because we were work in a field with an endless number of possibilities that we should start taking advantage of. While this story may be a bit autobiographical, it is meant to give hope to the other die hard specialty nurses out there whose circumstances may have changed. Whether you have to leave because of family, a big move, injury, or burnout, you are not alone and there is hope. This is not the end of the road, but an opportunity. The scariest dog is always guarding the door to the biggest prize. You will still find your way, because you my friend, are a nurse.
  21. anon456

    "Nurse, Heal Thyself"

    On January 1, 2016, I drove home after my 13-hour shift as a nurse in a pediatric hospital. I noticed his car was gone. As I entered the house, my daughters rushed forward and embraced me. One took my lunch bag, and the other took my purse. "He's gone," they said. I opened the door to my new bedroom, the one I was reclaiming after leaving it a year earlier for the spare room. It was in chaos. My clothes, removed from a dresser I had agreed to let him have, were piled haphazardly on a bench and spilled over onto the floor. He had apparently changed his mind about the dresser after all that, and it was in the middle of the room with two drawers removed and two others gaping open like a grotesque broken-toothed grimace. The mattress, now absent its frame, was sitting on the floor stripped bare. Trash and dust bunnies littered the floor. The bathroom trashcan and half the towels were missing. He left his soap but took the shampoo. But he was gone. Really gone. As a critical care nurse, I have seen the aftermath of many chaotic scenes: dirty, bloodied linens thrown into the corner, an abandoned IV pole with a half-used bag of fluid dangling an IV line that is no longer connected to the patient. Syringes littering the floor, and medication doses written in haste in marker on the window of the ICU, to be charted later. As I surveyed the bedroom that was to become mine again, the word "afterbirth" came to mind. As in, this was the remnants of a room where a very traumatic birth had taken place, but in the end, everything was going to be fine. This was the scene of the birth of my new life. We fell in love in college when I was just becoming an adult. He was a foreign-born grad student. I was an English major. I was strong, having survived a childhood of trauma and abuse. College in another state was my escape and my chance to find myself. I had started to do just that when I fell in love with him. He was gentle, respectful, mild-mannered, and very handsome. He was a good lover and a good friend. I knew he would never hit me or abuse me. But I was wrong. The person who makes a good lover and friend does not always make a very good husband. The man who was charming, charismatic, and always had a ready smile for strangers slowly became more controlling towards me as I became more dependent on him. It was a slow squeeze, one I didn't start to feel right away. It got much tighter when we had our children and I became a stay at home mom. When I felt the squeeze, I made excuses like, "he's just tired after a long day." I blamed myself by saying if only I was more . . . fill in the blank . . . he would not have gotten so angry. I am a giving person by nature, and I gave my all to try to make the marriage work. I gave it my soul. I lost myself in that process. His co-workers would come up to me and tell me what a nice man he was. And yet at home, he could be incredibly cruel, and then manipulate me to believe it was my fault he was being that way. When my youngest daughter, who had struggled with a myriad of health issues since birth, turned two, I realized how vulnerable we all were. I could not escape. And even if I found the courage to do so, I had no way to support myself and my two children. Inspired by my daughter's health problems, I started taking pre-requites to nursing school in night classes at the community college. My husband, who saw this an opportunity to increase our family's income, was supportive of my efforts. When that same child with the health issues started Kindergarten, I started nursing school on a full academic scholarship. When that child entered second grade, I was hired as a new grad into the pediatric ICU of a large children's hospital. Over the next four-and-a-half years I built my career. I became a seasoned nurse, a stand-in clinical supervisor, and a leader. But at home, I was still being abused. Two years ago I had a milestone birthday. I woke up one day and looked at myself in the mirror. I looked tired. I could not find that young woman that had made her escape from an abusive childhood into a new life. To make things worse my husband was now starting to control our daughters, now ages 12 and 15, in the same way he controlled me. One day my youngest, now a 12-year old, asked me, "Mommy, how can you stand him treating you like that?" I didn't have a good answer. I had decided a few years earlier to just endure for the sake of the kids. I thought I was being brave and doing the right thing, but I was miserable. Last year an acquaintance called me in tears, saying I was a good listener and she needed a friend. Over the next three hours, she told me about her emotionally abusive partner. After listening to her, I asked her what was the next step. I advised she leave him and started to help her plan it. And then I thought to myself, what a hypocrite I am! I was advising her to leave while I myself was continuing to come home to an abusive partner. Also last year, a long-time friend who I had not seen in over a decade, one who is a spiritual leader in her community and who once served in that role to me, came to town. She said she was concerned for me, that I was not the free-spirited happy person she remembered. I broke down and told her about the marriage. She hugged me. Then she held my shoulders, looked into my eyes, and said, "Nurse, Heal Thyself." I took her challenge to heart. Her visit awakened my spirituality that was once so important to me. I joined a spiritual community and surrounded myself with new friends that were loving and supportive, many of whom shared their own stories of survival. I started to meditate nearly every day, and to seek a direct connection to God. I started to value myself more. I reconnected and strengthened bonds with old friends who had seen me through the early days of motherhood and now we were raising our teenagers together. In July 2014 I began my BSN studies so that I could make my career choices stronger. I started to aggressively save money and quietly plan my escape. In early November of 2015, I told my husband of nearly twenty years that it was time for us to separate. He reacted by rolling his eyes and blowing me off. We had had this talk before. I told him I was serious, that I wanted him to leave by January 1st, 2016. If he refused to go, I would leave instead, and the children would be going with me. As I walked away he said, "This will blow over by tomorrow. It always does." But I was serious this time and I reminded him of that. He delayed the search for an apartment and packing. I found several for him within his price range, all of which he rejected. When I reiterated that the children and I would be finding a new home if he didn't move, he angrily put down a deposit on an apartment. There were many power games and attempts to control me through this process of untangling our lives, negotiating finances and child visitation agreements. My friends, some of whom had successfully left abusive relationships, helped me to recognize the elements of abuse, and helped me to find and keep my power while still remaining fair. As the move-out date approached, my casual friends and co-workers who I had not shared my news with, frequently commented that I was smiling more, that my step was lighter, and they asked what was going on in my life. My burden was lifting and people could see it. A few days before Christmas my BSN diploma arrived in the mail. That same week I sat for an interview for a new job. In the year of healing myself, I found the courage to contemplate leaving a good job in order to explore an area of nursing that was calling to my heart. It's now been nine days since he moved out. My children are starting to relax in our new home environment, no longer controlled by their father. My girls and I sit and watch TV together and snuggle on the couch, rather than them being holed up in their rooms after their dad comes home from work. They are starting to smile more. And now I step into my new life with arms open wide like a newborn baby. But I am not a newborn baby. I am wise and seasoned and strong. Yesterday I got a phone call offering me the new position I interviewed for. In the next few weeks, I am going to start my training as a hospice and palliative care nurse. I realized through my journey that quality of life is often forgotten and becomes secondary to the goal of surviving at all costs. I have seen miracles in my line of work that make some of the struggles worth it. But I have also seen patients whose lives turn into a long torturous ordeal before they finally let go or are allowed to let go. I am tired of torturing such patients. I want to instead focus on proving comfort and peace for whatever time they have left. As human beings, we often fight when there is no point to doing so- out of stubbornness, or fear of change, or loyalty. But sometimes the greatest courage is shown in the decision to let go and embrace joy and a greater quality of life.
  22. rn_xoxo

    You Might Not Want to Read This

    I am a NURSE. Did I make a mistake? Am I going to regret this for the rest of my life? These thoughts keep running through my head. I roll around in bed, eating pizza and feeling sorry for myself. Nursing school was so hard. It took up a lot of my time, energy, money...and let's not forget the mental stress. When I first started telling people I am a nursing major is when I realized how negative people can be and how they crush your soul a little without even realizing it. Strangers, family, and friends. I rarely heard words of encouragement "You know it is really hard to get into nursing school, you will be waiting forever." Fast forward. I applied to an associate degree program in my area. Got in. "So isn't a Bachelor degree what you need?" Fast forward. Graduation. "You know, it is nearly impossible to find a nursing job." "So you're going to be wiping people's butts for a living?" I just wanted to shake these ignorant people. I did not shed blood, sweat, and tears for someone to think that my only task would be cleaning feces. I could write a book on all the things I have heard about my choice in profession. The NCLEX was a traumatic experience. I told myself that if I failed it, that is it. I could not go through that type of exam again. I passed. I then started applying to what felt like a million nursing positions in hospitals. Not one call. Rejection emails flooded my inbox. I was tired of my job in sales so I decided to go ahead and apply to skilled nursing facilities. You know, what people look down on. Got an interview... got hired. I wasn't thrilled but I was happy to be using my license that I worked so hard for. Met with a group of friends from nursing school for dinner. One of us in the group of 6 landed a hospital job. That was no surprise since she had worked there 10 plus years as a Unit Secretary/Nurse Assistant. First thing out of her mouth "How much are they paying you?" I reluctantly told her, in front of everyone. "You should really get a hospital job." Insinuating how much more money she makes. I wanted to scream. Everyone congratulated her, but not me. My job wasn't exciting and I didn't make $50+ an hour. When will the negativity end? Why are nursing politics so prevalent? Who works where. Who makes what. New nurse versus seasoned nurse. Bachelor degree or Associate? Shouldn't we be united? Did we not all work hard for our license? Aren't we all smart? I was no longer excited to go shop for scrubs. I sat through orientation at work with a headache and just wanted to cry. Truth is, I am scared. I am a new nurse. I don't know a lot, I have a lot to learn. However, how can I feel okay when I don't think I will get the support I need to thrive as a nurse? Did everyone at some point feel this way? I wanted to help people. I am caring and compassionate. I genuinely want to heal and make a difference. I know it is not glamorous. I know it won't make me rich. Don't look down on me because I am a new graduate. Teach me. Guide me. Let me be great. It is not something you might have wanted to hear and I'm sure it didn't leave you with a warm, fuzzy feeling. But this is what I am going through. It is the truth and it is my experience.
  23. I had the weekend off, the first in a long time. My husband and I decided to ignore the world (the kids at their friends' homes for sleep overs) and binge on movies. Leaving my phone in the kitchen where we had made our dinner, we escaped to the back room with our dinner, drinks, and several movies. It wasn't until almost midnight when we returned to the kitchen to clean up our mess, and I noticed my phone was blinking. I had many missed phone calls and text messages. I dialed my sister-in-law - the last one to call - and the first words out of her mouth were, "Dad had a stroke." Unfortunately, due to the fact that I had been drinking, and the fact that my parents live four hours away, I had to wait until morning to "rush" to his bedside. Finding my brothers and their wives waiting for me at the hospital, I pushed into his room and found my mom holding his hand. Of course, when mom saw me, she started crying all over again. And there in the bed looking fragile and pale, lay my hero - my WWII Navy Vet who drove U-boats; my dad who once knelt down cradling my tear stained face and asked me, after my first fight in grade school, if I won; my counselor who listened to me cry when life didn't treat me "right". Fragile. Pale. He turned his head ever so slightly and held his hand out to me - the youngest and only daughter. I grabbed his hand and the strength and reserve that had kept me going until now rushed out in sobs. This is not the first time, nor the last, that I have had to run to the hospital to see a family member with a medical emergency. Nor will it be the last time I have had to put aside my own personal angst in order to do my job. How do we as nurses put aside our lives in order to care for those patients who are scared, frightened, anxious, and in pain? Do our own personal experiences make us better nurses? How do we go about providing care and assurance to our patients and their families without burdening them with ours? As nurses, we focus on caring for the needs of others. We are taught in nursing school to show empathy and compassion, have professional boundaries (not discuss our personal lives and problems with our patients), and act in a professional manner at all times. So - HOW do we DO it??? I have found that I have to compartmentalize my life. When I walk in through the doors at work, my home life is no longer the compartment I am working in, that door is closed until I walk out of those doors at the end of the day. Likewise, when I walk out the doors at work, that is exactly where work stays - all of the drama, heartaches, craziness -inside those walls and I, after years of working on it, do not bring that home to my family. I will say that is not always easy. For instance, one time I found out some particularly devastating news about a family member who was making choices that were destructive and shattering to my family. Knowing there is nothing that I could do about the situation, I had to return to work the next day, but my heart was breaking as I felt the weight of the world crushing me. Try as I might, I was losing my battle at work with keeping my tears in check - often ducking into the break room to take a deep breath, say a prayer, and wipe my face. I managed to do my job, but I didn't feel very effective. I decided to ask my charge nurse for a break and I called our hospital chaplain (who I adore and trust). She came immediately and listened to me have a mini-breakdown. After about 10 minutes of crying and blubbering, I felt better. I wiped away the tears for the last time, and went out stronger and more determined than ever to serve my patients. Once again, I was able to compartmentalize. "Sucking it up" is not always easy. However, we are professionals. Our patients are the ones in crisis, and when we are at work, we MUST make them our number one priority. If we have a problem making it through the shift - do whatever it takes to make it right. From asking your manager/director for a few minutes to talk so you can vent, to possibly taking the day off if you absolutely cannot function in the professional capacity. We all need a personal day - and there is nothing wrong with that. If we - as a professional nurse - absolutely cannot do your job safely and keep your patient your number one priority - you probably should not be at work! Nurses are a committed, tough, resilient, caring, loyal bunch - and we are able to cope with any number of situations. However, when it comes to a crisis in our own lives, it can sometimes throw us for a loop. Learning how to cope with our "stuff" is vital. Sometimes at work, I feel like that old poster of a duck on the water - all cool and collected above surface - but paddling like hell below the surface. I don't particularly think there is anything wrong with that. I am determined to provide every skill and all of my attention to my patient, and treat them exactly how I would have my family member treated in the same situation. I have stuff to deal with, like every nurse out there. We all have a story to tell, a crisis to crawl through, and a hell we may be living in, at any given time in our career. Are we able to hide that under the surface in order to be professional? Do we know how to cope, or what strategies are available to us, to keep us from cracking under pressure? Figuring out your strategy now can be crucial for future reference. You need to have a pool of information to draw upon so that one day, God forbid, you should have to go through trial by fire and have to provide care to a patient when you yourself feel like you could just curl up in a ball and cry. If you are a nurse who already has had to deal with a situation of tucking away your personal life in order to deal with your patient's crisis, please share your strategies! New South Wales Nursing Association cites 10 things nurses should do in stressful situations. I think these tips are important enough to share and some can be used when our own life makes it hard to work: Try to: Keep things in perspective Share your worries with families and friends Clear up misconceptions - increased knowledge helps alleviate fears Do not be too hard on yourself Worry will not solve anything; confront your problems and figure out how to solve them Set realistic goals for yourself Eat healthy and get regular exercise Utilize the relaxation techniques you were taught in nursing school!!! Think positive; enjoy new experiences; have fun with friends and family Be realistic - it is normal to have setbacks but they can be overcome On the day my world seem to fall apart when I grabbed my father's hand after his stroke, I probably would have wanted to scream if his nurse came in and started telling me about her problems. Instead, she was professional and caring. She calmly provided information and made us all feel like my dad was getting the best care. She was an amazing nurse. I don't know if she had any issues in her own life, but if she did, she kept them to herself. She made my dad her number one priority. I appreciated that. Reference NSW Nurses' Association. (2006). Stress management for nurses. Retrieved from: https://www.health.nsw.gov.au/nursing/Publications/stress-mngt.pdf
  24. Ironically, it was nursing school that made me realize that my symptoms of self-perceived madness weren't just eccentricities. I'm sure we all were self diagnosed hypochondriacs but the shoes actually fit and it clicked that I was the symptoms and cluster of behaviors that I'd wondered about in my high school psychology class. What kind of teenager thinks to themselves, "If I had any sort of mental illness, it would probably be bipolar disorder?" I'd never done much in depth exploring of mental illness prior to being plunged head-first into it while taking my psychiatric nursing class in undergrad. Hell, I minored in psychology and had even taked abnormal psychology, but it was learning the nursing interventions that made everything come full circle in my head. It was the group projects about coping skills that had me applying my classwork to my mundane life outside of the classroom. It turned on a switch that triggered me to seek wellness and health and to organize the clutter inside my head. Despite the fact that my mother and I saw a therapist while I was in high school for what she remembered as six sessions and I remember as two, I was constantly told that I was just "moody" and (my favorite) "just a teenager". Somehow, my early symptoms of hypersexuality, irritability and impulsivity were me "acting out" or "attention seeking". That didn't stop my mom from calling my after-school job, picking me up in the middle of my shift with silence, and then her and my father threatening to ground me and take away all of my privileges and electronic devices because I was writing sexually explicit notes with a freshman although I was a senior getting ready to graduate and was in a relationship. I spent way too much of my french class thinking of getting into people's pants rather than realizing the similarities between the Spanish I'd already learned and the French that was placed in front of me. That night, I threatened to walk out with none of my possessions and never come back, and I was serious. I screamed louder than I ever had in my life and though my mother threatened to drive me an hour and a half away to the only psychiatric hospital in the state that she knew of, she had no idea of what to really do with me. I spent the night at my grandmother's house, swearing to never talk to my parents again. There were other warning signs, like the deep pits of despair that caused me to stop "applying" myself in my classes, nearly failing AP English Lit and Biology, even though I ended up acing both of those exams at the end of the school year. There was my very first panic attack, during my timed AP biology exam where I felt like I couldn't breathe and that I was going to implode if I couldn't get out of the room. There were my nights of staying up until 0200 and getting up at 0600 without any problems OR caffeine. There were the notebooks full of exceptionally morbid poetry. I'm not even going to go into more depth about my dysfunctional relationship with my family because although it certainly doesn't make my diagnosis of mental illness any easier, it's *MY* problem to live with. Whenever clinicians ask me about my family history of mental illness, I always have to clarify, "You mean are there *symptoms* of mental illness, right? Nobody gets diagnosed in my family." I spent most of my spare time at the beginning of the Fall semester reading my psych nursing textbook cover to cover, devouring everything I could about bipolar disorder, GAD, anxiety disorders and it wasn't enough. I had quickly conceptualized what was wrong with me, but it wasn't until I found myself sitting on the floor of my apartment after having run out to the grocery store at 0300 to buy glitter glue, die cut letters, stickers and colored paper to embellish my teaching plan for my the next day, where presentation was only worth 5% of my grade for the assignment that it actually clicked that I was likely driving everyone else around me absolutely insane and that I might be having a hypomanic episode. I was working 2-3 on campus jobs in addition to my classes and that still wasn't enough for me to keep the bills paid and afford everything that I thought I just *NEEDED*. I promptly scheduled an appointment with the counseling center on campus to see a therapist and then the school psychiatrist shortly after. I don't much remember the counselor that I saw at the time, but I do remember the psychiatrist and the first few words he said to me. "I'm no better than you are. I have the prescription pad and you don't, but you know what's going on in between your ears better than I do." He started me on Klonopin after our first appointment and then he started Lamictal shortly afterwards. It's been a whirlwind of ups and downs, back and forth, and side to side ever since. I've scared a therapist, who had no idea how to get me to the hospital after a session in which I told her that I just couldn't handle things anymore. (Gee, why didn't she just call 911?) She actually let me drive home to pack some things for the hospital, on the promise that I'd keep her posted. I've quit a job because I was bitten by a patient and nearly had a panic attack on the floor in front of my colleagues, and even though another staff member was hurt too, there was no de-briefing with security or my nurse manager present to explore how we could avoid the situation from happening again or what warning signs in the patient we had missed. I decided to apply to teach at a high school although I was in no way really prepared for the job (my teaching practicum at a community college didn't cut it) and I stressed myself out even more than I had been on the floor. I burned myself out even more and found myself wanting to go back to what I knew, seeing and helping people who weren't that much different than me. It's been almost 5 months since my last medication overhaul and although things are still shaky in my world, I feel more grounded than I ever have. I pull out all of my prescription bottles at the beginning of the week and fill two medication calendars, one for my AM/PM meds, and one for my afternoon meds. I know I'll probably never be able to work straight night shifts ever again. I know that I need to work harder at setting limits with patients than any of my colleagues will ever have to do. I know that I need to check and double check things and then still spot check because I end up letting myself get over-confident. It will always sting when I hear a co-worker say, "Oh that patient is just attention seeking." (Maybe if you pay attention to what they're doing or saying, rather than how that makes you feel, you'll remember that they're in the hospital for a reason.) I'll bite my tongue when I get told, "That patient needs PRNs around the clock because they're out of control." (Is there something that's triggering them that we should be more mindful of? Are we doing our best to notice warning signs and address them *before* the patient gets out of control?) They say "It takes one to know one," and I think that's a pretty accurate statement. I'm not saying that you need to have mental illness to work with patients suffering from mental illness, but a.) it helps and b.) we all have our issues and lie somewhere on the mental health/illness spectrum. It helps to acknowledge that we're human and mental illness is the most pervasive illness among those 18-25. Take a look around and recognize that it's not a death sentence but it can become one if it's ignored or not treated. After all, we're all a little bit mad, right?
  25. spotangel

    The Desert Angel

    I settled down to sleep. The ambulance cruised the silent highway at 80 miles an hour. "Nothing like the rush we were in, going to the city," I thought wryly. Faya,the Saudi Arabian driver in his flowing white robes looked straight ahead as he drove back to Thar,a small village in Saudi Arabia. I had been working there for 3 years.We were on a return trip from Najran,the nearest city, 150 miles away. I was a nurse for 3 years and had my hands full with the pt that we had taken to the hospital. Amina was 45 year old having her 7th child.She decided to give birth in the ambulance. Her baby was premature, breech and had a cord around the neck. I delivered the baby, reviving the baby as Faya flew down the highway at 120 miles an hour! Amina then had postpartum bleeding. I shoved my gloved hand into her womb and squished her uterus against her pelvis trying desperately to stop the bleeding, while I held her newborn in my other hand and fought for balance in the speeding ambulance.The ambulance floor was covered with blood. We reached the hospital. Faya scooped Amina, blood all over his pristine white robes as I ran in with her premature baby girl into the ER. They both made it. We got new clothes, washed up the ambulance and set back home. It was 2am. I was happy. A 23 years old, who saved 2 lives. Life was good. I said a prayer of thanks and fell asleep. Something woke me up. I rubbed my eyes and looked around. It was too quiet. We were off the highway. Desert all around, no tree,no house in sight,not even the lights on the highway. "Faya,what happened?Why are we off the road?"'I asked in Arabic. He did not speak English. My Arabic was basic. Faya had a strange glitter in his eyes. I been meaning to speak to you for a long time." About what?", I asked puzzled. He then went on to tell me that he wanted me as a girlfriend. My instincts screamed to run as I fought to stay calm. I looked at the moonlit sky filled with huge stars and sent a silent prayer for help. My hand inched in the pocket of my black gown that I wore over my white nurse uniform .I clutched the rosary that I always traveled with and prayed, "Queen of Angels!Queen of virgins! Protect me. God! Help me!". I looked at Faya sitting there with 2 guns,a sash of bullets and a wicked knife on his side.What hope did I have? As I looked at him a strange warmth enveloped me. As if I was being covered by a warm blanket. My mind became razor sharp and calm at the same time. I started speaking to Faya in eloquent Arabic that I did not know but for some strange reason could understand. I heard myself talking with a wisdom beyond my years. I asked him 5 minutes of his time and dissuaded him from hurting me. I appealed to his sense of religion, spirituality, reminded him of his daughter who was my age and asked him to ask himself if what he wanted to do was right? I told him that I still trusted him to do the right thing. I told him that now it was his decision to make, whether he touched me or not or took me back home. I then stayed silent. It was the longest five minutes of my life. There was no place to run or hide. I ,the youngest of 10 children, loved and protected all through out my life was all by myself. Only God could change his mind! When he looked up at me, he had tears in his eyes. He apologized for frightening me, asked my pardon and then turned on the ambulance. We were home in an hour. I went to my room, locked the door, sank on the floor and wept. I was so scared. I did not tell anyone of this incident. I left Saudi a few months later. I later came to New York and now I am settled here. When my sister visited me she gave me my first angel as a gift. Since then I have been collecting them. I have an unusual liking for angels with big,intricate wings. I know it is because I felt their power and protection one starry night in a desert!