Anti-vaccination argument is the new Intellectual Feudalism

Reading the comments on the anti-vaccination are eye-opening.  As in frightening enough to make one tachycardic…and diaphoretic. The thoughts are so backward; I am reminded of the Monty Python “I thought we were an autonomous collective” skit. Those against vaccinations remind me of the intellectual state held by the masses in the Middle Ages.

“There’s some lovely filth down here.”

Link #1: Facebook Anti-Vax Comments






5 Traits to Look For In A Manager


5) Great managers are advocates. They help you work towards improvement, as well as present you in the best light possible to higher management.

4) Great managers are accountable.  They hold themselves responsible, as well as their team members when things go wrong. They look for solutions, not somewhere to place blame. Problems are framed as opportunities to address issues, not baggage for employees to carry around.

3) Great managers are honest. They give credit where it’s due. They lead fairly, and apply rules and policies equally to each employee.

2) Great managers confront problems. They address small problems before they become bigger problems.

1) Great managers praise publicly, and correct behaviors privately. Unless a behavior is so egregious that it needs to publicly addressed, then the redirection should be to a private area to handle the issue privately.

This applies generically, not just to nurses. Having been in the workforce for several decades, I have seen and experienced these traits (as well as their opposites, unfortunately) in a diverse range of work environments.  If one does not experience this in their work place, the intensity of the problems will vary.  Also, the dynamics of the situations may or may not change – especially if the willingness to change only exists on your part as an employee.


Embrace The Chaos

Shift report can be a funny thing. Your patient assignment, even if you have had the group before; can go in many directions. You may have a patient whose vital signs are “circling the drain,” or lab results have just come back all wonky.  Altered mental status, sometimes in the form of ‘sundowners’ can make a quiet evening a noisy/busy one.  There have been shift reports where I felt like that last click on the first hill of a rollercoaster. Butterflies in the stomach. You know it’s going to be a wild ride, but you don’t know where it will go. This is where I came up with the phrase, ’embrace the chaos.’  You fight that new nurse urge to go in the opposite direction of the crisis, and step towards it.  You tap into your spiritual center to remain calm, build upon your desire to help people, then tap into your skill sets and knowledge to work towards saving the patient.

However, those evenings that feel like all the little things spin out of control.  You begin to feel like everything is closing in. Perhaps the feeling of being trapped in a strange medical game show.  I think these are the moments that separate new nurses from experienced ones. As the saying goes, “new nurses run/old nurses don’t.’  Experience nurses work smarter, not faster.  I was able clear my mind, take a deep breath, then attempted to use my best critical thinking skills to determine what I needed to focus on first.  I also found out that all of the rituals I had developed to improve my time management skills, including those during med pass paid off.  Reading this, I feel that I am making smaller events seem larger – which is probably the case. However, I think I had a glimpse into even more intense rapid response/codes in the future.

Not that I have had many of these moments, but I have had a couple. A few cases had to do with hypoglycemia. Another case, a patient I had just collected blood labs on, came back with a 7.2 Potassium level. The free charge was very supportive. There is a set protocol, listing everything to do – include contacting the doctor.  The supplies were organized. The checklist was followed. Luckily, everything turned out well. It was scary, but a manageable, learning moment scary.  I was able to ask questions while things unfolded. Since then, I have also seen other nurses go through crises with their patients.  The sense of teamwork and commitment that my peers and I share reinforce the decision that I made to join this team. Nursing rocks.

Nurseeyeroll: When Your Patient Starts Crying

If they really trust you to do a good job with their loved one, that will put them at ease and support them by taking one big stressor off their plate. I don’t mean all of the technical stuff like getting all of your charting perfect, interpreting lab values, giving all of your meds precisely on time, or consulting with the interdisciplinary team. I mean the more basic stuff. Things like taking extra time to comb their hair, getting their favorite flavor of Jello, or trying to connect with them and make a joke to get them to laugh…that can really mean the world to someone. If they trust that they or their loved ones are safe and cared for in your hands, that itself provides emotional support.

Nurseeyeroll: When Your Patient Starts Crying

Nurses get front row seats to every aspect of patient care, including facing and dealing with the sometimes-tangled arena of emotions.  The post I am sharing offers some good insight into managing those situations.

Troubleshooting IV Pumps: How To Stop (Some) Of The Beeping


These machine used to frighten me in nursing school.  They have evolved into being an occasional annoyance when they make their beeping sound (or otherwise choose not to work they way they are supposed to). Here are some tips for newer nurses:

1) Don’t overthink things. Make sure the pump is plugged in, and not running on battery power. The pump pictured above will beep when the battery is running low. This can be really easy to check, especially when you set foot in the room at the beginning of the shift.  Before you leave the room, add checking the plug as part of your routine – along with making sure the bed is in the lowest position, bed/clip alarms on and functioning, three rails up, etc.

2) “HIGH PRESSURE” alarms can be somewhat tricky to identify. It can be as simple as making sure that the IV line is not kinked, or tucked under the patient from an earlier bed strip. It can also occur when the IV site is located at a joint, antecubital or wrist.  You can try stopping the pump, adjust the IV tubing, then start it up again. If that doesn’t work, sometimes swapping out the IV pump and/or switching out the IV tubing will work. However, if you are only dealing with small IV infusions; switching out tubing is probably out of the question as you’d waste over 20 mls of medicine with the switch out.

3) “AIR BUBBLE” alarms, which used to terrify nursing students, can be dealt with in several ways. My favorite would be the “guitar strumming” method, where you hold the IV tubing near the pump – then “strum” the line – to work air bubbles away from the pump. You can also consider re-priming the pump, but that could keep you busy for awhile. Remember that “time management” thing?  The bad news is that even microscopic bubbles will set off the alarms.  The good news is that a few tiny air bubbles aren’t likely to harm the patient.  The bad news is that there isn’t a general consensus on what that amount it.Here is a National Institute of Health article on embolisms.  Use your own critical thinking skills to assess your own pumps, please.

4) If all else fails, read the error message on the pump.  I am not familiar with ALL pumps; just the electronic nightmare generating machine pictured above. If you believe there is something wrong with your pump, take it down immediately! Follow your facility’s guidelines for labeling out-of-commission/broken items.  Pumps that aren’t working correctly could mean no medicine is given (bad) or that too much medicine is given too quickly (very, very bad).  Again, use those critical thinking skills for your own situations, please.

5) Ask peers for help. Try to do some troubleshooting on your own, but don’t be afraid to ask others for help.  You are just looking for ideas, not necessarily have them do it for you. Remember what they show you. Thank them for their time. In time, you will develop your own troubleshooting bag of tricks.