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.

Five Things That Can Make You A Great Coworker

nurse

1) Be Willing To Do The Work – Some shifts will be busier than others, and time management skills will always get tested.  However, the work still needs to be done. You are likely to get more sympathy from coworkers, and perhaps even help, if you are actively trying to get your work done.  Of course, some work environments are more supportive than others.  Assess and prioritize the tasks you have left, then do your best. 

2) Be Approachable –  Show a willingness to help out, and make time to help coworkers when you can. This applies to other nurses, as well as support staff.  If you are in the middle of some important task (med pass with a patient, for example), tell the coworker that as soon as you are finished that you will be right there.  Even if you are held up or delayed, check in on them.  You can offer to get supplies that may have been forgotten, which if the room is in isolation, that can be really helpful.

3) Admit when you are not sure – This is true, especially when you are a newer nurse.  If you are to do a particular procedure or task, and you are not ABSOLUTELY clear on how to do it; ASK FOR HELP!  Giving a new med? Use the research tools available, then ask another nurse if something isn’t clear (maybe, you noticed a conflict on the amount given, or the dose seems high, or it is incompatible with something the patient has, etc.) It is not a sign of weakness. It is a sign of strength.  Show some critical thinking skills and bounce your questions off an experienced nurse (or even the charge nurse).  Ask for clarification if things don’t quite make sense.  Boldly charging into situations where you are not critically thinking can generate some serious consequences. Read labels. Confirm your patient with two unique identifiers. Re-read Doctor Orders. Clarify vague orders. Be thorough.

4) Reach out to your coworkers – Everyone is part of the treatment team. You are all providing care for your patients to help them heal.  One of the best ways to lighten anyone’s worries is knowing that help is available. However, this functions under the assumption that you are able to get your own work done. If you have a free moment, ask others if they need help.  Being willing to roll up your sleeves to help with a complete bed strip, or even answer other nurses callbells…maybe even address a beeping IV or feeding pump will go a long way. Keep in mind that Rule #3 applies here, too. If you don’t know about a patient’s routine, just tell the nurse who is managing that patient about the beeping pump.  You can even get clarification from them, and still take care of the issue – if that nurse is busy in another room.

5) Be grateful – Thank anyone and everyone who provides help, answers a question, shares a resource, gives you a helpful tip or otherwise makes your life easier. Give credit where it is due.  Use words like : please, thank you, and you’re welcome.

Blog: Nurses That Vaccinate

Nurses That Vaccinate: An Open Letter To Jenny McCarthy

I found this blog post while surfing. I am sharing it because it is something that vaccinations are something that I support….and that I am annoyed how people let celebrities trump science.  There are many other television celebs that really need to step off screen and shut up.

One of my research papers in nursing school included this topic, specifically, on the topic of Thimerisol (a mercury compound that used to be used as a preservative in vaccinations).  This topic was made visible to the masses when Jenny McCarthy presented her son as being autistic as a side effect of receiving vaccinations with Thimerisol.  Her desire to champion a cause led her to becoming a mouthpiece to a group of people who do not support vaccinations (sometimes called “anti-vaxxers”)  One of the main sources against vaccinations was an English study done by a Dr. Andrew Wakefield.  His study was published, presented to the scientific community, and spent about 10 years in the public eye. However, the scientific community questioned the study. A subsequent investigation found that Dr. Wakefield had distorted the data and the study was discredited – even retracted by the British Medicine Journal that originally published the paper.  Unfortunately, many decided to continue to embrace the emotion to allow them to ignore the data to continue to vilify vaccinations.  As it turns out, Jenny McCarthy has also retracted her stance against vaccinations.

The Thimerisol issue, by the way, was created when the pharmaceutical industry came up with a solution to preserving vaccinations.  Early vaccinations, when they were first becoming mass produced, would spoil and either lose efficacy and/or become toxic with contaminants.  Thimerisol was discovered to nearly wipe out spoilage, and make vaccinations more stable with a longer shelf life. They were used for decades, but came under scrutiny in the 1970s.  Studies were done to see if there was any effect. The research done my many countries, using wide demographic populations, over many years yielded answers. There was either no effect or no direct correlation between the use of Thimerisol and any illnesses/disease (including autism). When I have time later, I will create a resource page to show the articles I found on this (and many other issues).

Yes, Thimerisol is a mercury compound.  However, mercury comes in three forms: elemental (think: early thermometers), methyl mercury (see: Minimata disease), and ethyl mercury (does not bioaccumulate, does not share toxicity as other forms of mercury, and has even been shown to be excreted from the body, babies included). Thimerisol, a member in the ethyl mercury group, was still phased out of vaccinations as a precaution. By the time Jenny McCarthy brought this issues to the public, Thimerisol had already been taken out of nearly all vaccines.

Science may not lie, but it can be presented by people who have their own agendas. Even without celebrities like Jenny McCarthy (a nursing school drop-out, btw) muddying the discussion waters, scientists who let either emotion or funding source determine the conclusion of their results is just as damaging. One of the saddest things about this (and related issues) is that there seems to  be no shortage of people who do not grasp the value of science.  I fear that we are returning to an intellectual age much like that found in the Middle Ages.  Messhugganuh.

-D

5 Things I’d Like To Tell My Patients | RN Meets World

5 Things I’d Like To Tell My Patients

Source: 5 Things I’d Like To Tell My Patients | RN Meets World

The text from the link :

I think you all have an idea of what I’m talking about, whether you’re a nurse, a CNA, a student, or even an employee of one or your hospital’s ancillary departments. There are always those things, the things you wish you could say to your patients that would be taken as respectfully as you intend them to be. The things that as healthcare workers we experience every day, but know our patients have no idea just the burden that it places on us when these seemingly insignificant actions are put into play.

A few weeks ago, I asked the question of If you could say anything to your patients, what would it be and it was met with an amazing response. Many of your ideas had me laughing and nodding in agreement. So without further ado, here are five of what I considered to be the most universally applicable responses:  

  1. When you use your call light, please tell me why you are calling. This is huge, and when it comes down to it, it will save you and I both some time. While “I need help” or “I need my nurse” will get you a response, it is incredibly helpful to know what I will be walking in to. Do I need to come personally, or can I send a CNA if I am tied up? Are you having shortness of breath or chest pain that would necessitate me dropping everything I am currently doing with another patient, or do I need to swing by your room to deliver some nausea medicine as my next stop? If it’s just another can of Coke you want, let me know so I can grab it on my way down to your room instead of having to make another trip.
  1. Please, put your cell phone down. This isn’t airport security, or the DMV, but I would appreciate the respect of putting your phone down when I am trying to ask you questions. If you feel up to it, talk all you want on your own time, but I am here to be your nurse, not your personal attendant. To “come back later” puts me at a serious inconvenience when I’m trying to juggle the care of anywhere between two and seven patients. I understand that emergencies come up, and you may need to pick up your phone to quickly reassure your loved one who may panic if you don’t answer that everything is okay, but please, please, please don’t use med pass and assessment time as an opportunity to engage in a catch-up chat with your long lost cousin who wants to make amends now that she found out you’re having a health scare. Just call them back.
  1. Do you really understand what 10/10 pain truly means? I don’t doubt you are hurting. I can see it in your vital signs. I can see it in the grimace on your face as you try to get comfortable in a hospital bed that is anything but. I can see it in the bumps and bruises and incisions that mark your body. I understand that pain is subjective, and if you’re one of the unlucky that’s been given the curse of chronic, unremitting pain, I may not see anything at all because you’ve learned to so bravely continue about your daily life and not allow it to hold you back.10/10 pain means the worst possible pain you could ever imagine. Is there not anything that could possibly happen to make you hurt worse? I’m not the one in your shoes, and I can’t claim to feel what you feel, but I have a hard time believing that the discomfort you are feeling from your nitro headache is anywhere close to how you would rate losing an appendage. A pain scale is subjective, I understand that, and what you are able to tolerate could be vastly different than that of the person next door or even me personally. But still, give some consideration to how it would feel to have an arm or leg ripped off or unsedated surgery and then tell me where your pain level falls.
  1. Sometimes making you happy and making you better are not one in the same. When it’s possible, I promise I will do everything in my power to give you the best of both worlds. But when you’re scheduled for an endoscopy in a few hours, I’m not going to feed you. When your blood pressure is reading dangerously low, I may not be able to, in good conscious, give you the maximum dose of your pain medication. If you are admitted for heart palpitations, I can’t give you your daily cup of caffeinated coffee. This isn’t me being mean, lazy, or restrictive; it’s me being responsible and caring more about your health than your happiness when the two worlds are mutually exclusive.
  1. I wish you could see what I truly do. I do this job because I love it, and couldn’t imagine myself doing anything else. But when you make comments like “You’re not doing anything” or “My nurse was barely in here this shift” they can be incredibly hurtful, because you don’t see the half of what I do. For every ten minutes I’m in your room, it’s likely that I’m spending an hour managing your care from the command station that is the nurse’s desk. I’m on the phone with doctors, conversing about your latest test results, updating them on your condition, even suggesting interventions that I feel will make you more comfortable. I’m walking down to the lab to hand-deliver your blood and specimens. I’m double checking with pharmacy to ensure the doses and frequencies of your medications are correct for and do not put you at risk with their interactions. When I’m not doing that, I’m on my computer, documenting every little abnormality I saw on my assessment so that changes in your condition can be quickly met. I’m reading through your orders the notes that the doctor made and making sure that I’m up to date on your treatment plan and that nothing is getting lost in the shuffle.

So please, coming from a nurse who cares about her patients and care about her profession as I feel like the majority of us do, don’t say that I don’t try.

Author note: I really liked this list, so I am sharing it…and encourage comments from others (including nurses). =)