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Posts from the ‘Miscellaneous’ Category

May 1

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Why I Stopped Blogging

I recently read this on the AJN blog regarding old blogs that don’t get updated anymore and it really made me chuckle:

“. . . maybe blogs should go to a blog graveyard at some point, or be given a proper burial, or demolished like old buildings in a great controlled cinematic whoosh of collapsing pixels and pixel-dust.”

And of course I thought of this nursing blog. It’s a good a point. So many blogs out there, frozen in time. It would be nice if there was a way for all of this content to degrade gracefully.

So why did I stop?

On one level it’s because I stopped being a nurse. The reason I started this blog was to tell some stories about what it was like to be a nurse, and to process some of the frustration and anxiety of the first year in nursing. As I became more comfortable in my role, the blog evolved into more of a nurse’s perspective on health care, rather than just storytelling. Then I took a hiatus from nursing and this blog kind of stalled.

Life got difficult.

I had a child. Then two more. Possible flirtations with postpartum depression. And then my brother’s suicide, which basically sent me reeling. As I gradually began to piece my life back together, it occurred to me that it had been more than three years since I’d even worked a nursing shift. I’ve been ambivalent about a return to nursing. I wish I had made more progress in my career before I started having children. But when you start a nursing career in your mid-thirties and haven’t started a family yet, let’s just say that time is not on your side.

I haven’t exactly missed bedside nursing. On the contrary, I often have anxiety dreams that I’m back in the ICU and am clueless. I have aspirations of doing something else. Something I’m better suited for. But I’ve missed the community of nurses that exist online. I’ve gone in and out of following people, reading their blogs. This was mostly out of frustration that my own nursing career had stalled, and so I didn’t feel like reading about other nurses.

So that’s all. Just wanted to stick my head out there and announce that PixelRN isn’t ready to collapse in a whoosh of pixel dust. Not yet anyway. And I’ve been feverishly working on a new project, a nurse blog aggregator (sneak preview!) that I hope will revive some interest in nurse blogging. More on that, soon!

Oct 3

nurse_ratched

Nurse Ratched: Movie Villian

“Nurse Ratched is ranked fifth among the greatest movie villains of all-time by the American Film Institute, behind Dr. Hannibal Lecter, Norman Bates, Darth Vader and the Wicked Witch of the West.”

via Nurse Ratched returns to Salem | Statesman Journal | statesmanjournal.com.

May 8

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Nurses: Do you have an exit strategy?

A slightly disturbing thing that I noticed this summer was the amount of nurses who have an exit strategy for leaving the bedside. It seemed like the majority of nurses I worked with were planning their exodus from bedside nursing in the form of CRNA school, NP school, or perhaps even just getting a MSN in order to obtain a more administrative role.

It certainly doesn’t leave one with much hope for the profession. I wonder if other professions experience this phenomenom (i.e. how is the best way to put in my 2 years of drudgery and then advance?)

On the other hand, one thing I noticed was the advantages of raising a family when one parent is a nurse, because there is such a variety of shifts you can work. Here are some examples – these are all people I know:

  • A nurse who does home health care during the day so she can be home when her kids come home from school.
  • A nurse who works 4 weekend ICU shifts a month and spends the rest of her time staying home with her young children.
  • A nurse manager who works M-F, 9-5 and has her kids in day care.
  • A male nurse who works nights and weekends so his wife (also a nurse) can stay home with the kids
  • A female nurse who works agency so her husband can stay home with the kids
  • A nurse who mostly stays at home with her child but picks up contracts here and there when the family finances call for it (guess who that one is!)
  • And I know a plethora of nurses who do the conventional ICU schedule (every other weekend, rotating days and nights) while raising a family with a spouse who quite often works an opposite schedule.

This last option is hard. Extremely hard. But if planned right, it can work to maximize the time that your family spends together.

I remember reading in one of my nursing theory textbooks that these types of nurses who fall in and out of the profession and will only work full time when it’s convenient for them and their family are very bad for nursing. They don’t contribute at all to advancing the cause of obtaining more power and respect for the profession.

And yet where would nursing be without them? For the most part they are the ones who aren’t working on an exit strategy, because it all works out so well for them.

Feb 27

The Latest in CPR Techniques

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(Foreman performs the life saving “titty twister technique” after House OD’s on methadone)

Renewed my CPR today. In the beginning I was so blase about it. I couldn’t believe that the content could actually take up 4 hours and I complained about it. But once I was there I had a better attitude because I remembered that this is pretty important stuff, and so it’s important to practice and brush up on your skills every once in awhile. By the end of the class I was really starting to thing that I am ready to go back. I’m not afraid. It’s going to be a good thing. Oh sure there will be some tough days (and nights) but I’ve done it before and I’ll do it again.

A couple surprises, though:

1. They didn’t mention the Stayin Alive factor. Something I find incredibly useful in keeping pace.

2. They didn’t mention the “titty twister method.” For those of you unfamilliar with this it was on House last week. House went into respiratory arrest and Foreman brought him back with an heroic titty twister. My initial thought? This would be perfect for those who like to fake seizures.

Aug 26

What Does it Really Take to be a Good Nurse?

I’ve often heard the complaint that nurses aren’t handmaidens and shouldn’t be treated as such. Head Nurse does a great job of addressing this in her post Handmaidens, Helpmeets and the Problems of Nursing. As much as I want to believe this, though, I have never been able to convince myself that this isn’t true.

To illustrate my point, I’ll give you a day in the life of working in the recovery room:

The charge nurse hands me a paper with a very minimal patient report. It usually includes the name of the procedure the patient had, any outcomes of the procedure, current vital signs, sedation and any other meds the patient might have received.

The patient is rolled in to the recovery room. I hook them up to the monitor and do a very minimal assessment (Are they awake? Are they in any pain? Are their vital signs within normal limits? Is the incision/puncture/drain site dry, clean, and intact? And most importantly, do they have a ride home?)

When I’m finished, I call the waiting room and let the family member(s) know they can come in.

I record vital signs and check on the patient’s site every 15 minutes for an hour. Sometimes this is extended to every 30 minutes for the next hour, sometimes it isn’t. If the patient is hungry or thirsty I’ll give them a beverage, perhaps some crackers, maybe even a turkey sandwich. Sometimes I will help them on to the bed pan. If the patient is nauseous, I call the doc and ask for some phenergan. If the patient has pain issues, I call the doc and ask for some Tylox.

If the patient’s vital signs fall out of wack I page the appropriate MD. If they fall precipitously out of wack I will have someone go to the procedure room of the appropriate MD and grab him or her. If they have no vital signs I will imediately call for help and start ACLS (this has never happened.) Sometimes the patient will bleed, or develop a hematoma at the puncture site. If this occurs, I hold pressure until it stops and notify the MD.

If the patient is being admitted I call report to the floor nurse. I unhook the patient from our monitor. If the patient is going to a monitored floor, then I hook them up to a transport monitor and take them to their floor. If the patient is going to a non-monitored floor, then I arrange to have a patient escort take the patient.

If the patient is going home, I give them some pre-printed discharge instructions, verbally explain them to the patient, and answer any questions. Then I remove the patient’s IV(s) and send them on their way.

Is what I’m doing skilled and technical? Yes.

Am I using autonomy or intellect? No.

Am I using my skills of compassion and care? You bet I am. One of the only things that make the tedium of nursing bearable for me is when I get a patient who is anxious, or has questions, or wants to talk about their disease. They talk, I listen. I might even hold their hand. I answer questions. Sometimes I ask them questions because I know that they just need someone to talk to. They want someone with medical knowledge to help them process what is happening to them. I’m happy to be that person.

To further illustrate my point I’d like to say that some of the best, most effective, and knowledgeable nurses I’ve seen are either diploma nurses or associate degree nurses. It doesn’t take a bachelor’s degree to do what they do. So why is there this big movement to “intellectualize” the profession of nursing? At the university level they like to teach about the politics of the profession, and what nurses can do to gain more power. If that’s the agenda they want to push forward, fine. Maybe some day they will gain power and change our healthcare system for the better. But I think it does future nurses a disservice when they find themselves in their first hospital job, expecting to have all these autonomous, intellectual tasks but instead find themselves doing all the skilled, technical, and menial stuff. Sometimes I think that what the nursing shortage really comes down to is that there are these tasks surrounding patient care that need to be completed around the clock, and there aren’t enough nurses willing to do this kind of work.

But if the nurses aren’t going to do it, who will?