Monday, December 30, 2013

Honor Guard

The fire service and emergency medical services are big into ceremony.  My husband is a fire chief and I attend a LOT of ceremonies.  They definitely stand on ceremony, just like the policy and the branches of the military.  Funerals are actually beautiful affairs in the fire, police, and emergency medical services; there's nothing like those bagpipes to get the tears flowing.

My friend Lori, you saw her in a photo with me while wearing our caps upon graduation from nursing school last month, lost her aunt a few weeks ago.  Her aunt, Angie, was a nurse and died at 93 years old.  She was, in Lori's words, "ready to go".  Here's her picture:

courtesy of Sharp Funeral Home

Apparently, Angie was a member of the St. Anthony Nurses Alumni Association and would participate in honor guard activities at the funerals of others who had graduated from St. Anthony's School of Nursing.  The honor guard goes to these funerals in full white dress with gloves and blue capes, the typical uniform of the 1940's.  Here's photo (not from St. Anthony's, but you get the idea):
courtesy of
Some of these nurses showed up at Angie's funeral, along with American Legion Auxiliary, to honor her life and service.

Isn't that a great thing?  We should learn from the fire, police, military, and emergency medical services and honor the lives of nurses by standing on ceremony like this.  Nursing is a noble and respectable profession and should be celebrated as such.

Friday, December 27, 2013

Uniform Fun

I'm starting a new job in January and my former employer provided scrubs, so I need new uniforms.  I'm going to miss the purple of my last job (in more ways than one) but I think I look good in navy, too, which is the color I need for my new job.  Well, navy or white, but white has never seemed that practical for nurses to me. 

So...I did a little shopping today at the uniform store.  Uniforms for America - right here in Plantation, Florida, and a very nice shop.

I know I've posted about it before, but it's amazing how much uniforms have changed!  One of the unit secretary's at my last job had some pants with the "koi" label on them at my last job and I thought they were so cute.  I had to order the right size in navy, but I went ahead and got a white pair because they were have a special.  White pants - guess I'll have to go underwear shopping, too.

I tried on the Grey's Anatomy scrubs, but they didn't fit right.  No surprise, I've never been a huge fan of the TV show, either.

I did get three sets of pants and tops with this cute little insignia on them. 
I LOVE all the pockets on both these pants and the koi pants.  Maybe I'll actually carry my scissors again!

Thursday, December 26, 2013

Clara Barton, Independent Nurse

Photo courtesy of

Clara Barton's birthday was yesterday, December 25th, Christmas Day. 

Founder of the Red Cross, I always thought that Clara Barton was a nurse and I know that many times she is described as having been a nurse.

Actually, Clara Barton was a teacher.  Impressive - she became a teacher at 15 and started the first free public school in New Jersey - but like many others of the time, she "nursed" patients during the Civil War and was considered, therefore, a nurse.  "Independent Nurses" they were called at the time.

Clara was not educated as a nurse formally, she learned her skills while caring for her teenage brother as he recovered from some sort of accident.  The 1800's equivalent of staying at a Holiday Inn.

She was never paid for her work with the Red Cross and, in fact, used her own money at times to support the organization, but there were rumors of financial foul play when she left the Red Cross; she also was possibly the first woman to work for the US federal government. 

Happy Belated Birthday Clara!

Monday, December 23, 2013

Dear Santa

*photo courtesy of
What would nurses ask Santa for?

A self-cleaning commode
A magic pen that makes doctors' handwriting legible
A magic pen that never gets lost
Computers that always work perfectly


That everyone is well for 24 hours over Christmas so that no nurses have to work.

It doesn't hurt to ask, right?

Friday, December 20, 2013

The Bath Ritual

 Yesterday we talked about how patients' baths are the barometer for how our shift is going.  After writing about it, I haven't been able to get it off my mind.  The bath seems like the absolute most basic of nursing care and, certainly, a task that has been delegated to others as the role of nurses has evolved and expanded.  But it's still at the heart of nursing care.

If the bath is our barometer of success, it is also the barometer of care as perceived by the patient.  There's a significant amount of literature out there about how patients' bathing is connected to their satisfaction with care.  Baths matter to patients.

A bath is also the one single thing that can impact a patient the most.  Have you ever been the nurse who has gotten to put a patient recovering after a very bad illness or injury into the shower for the first time since getting sick?  Truly, it is almost a religious experience.  I, myself, can remember vividly how I felt about getting to take a shower after abdominal surgery many years ago, even after the other details have faded away. 

Nurses all have their own method for bathing patients, even though we basically learned the same method in our initial nursing program (I think bathing came before even taking vital signs, didn't it?). We know the perfect number of towels and how we like to place them, where the soap should go, and in what pattern the other bathing supplies should be laid out. 

It's interesting that this one aspect of nursing care goes back to what is considered the beginning of modern nursing, the influence of Florence Nightingale's first linking of cleanliness to health in the 1800's, and is still such a big part of the care we give in 2013.

By the way, how much happier would patients AND nurses be if their baths looked like the one pictured above?

Thursday, December 19, 2013

At Least The Bath Is Done

Have you ever noticed that patients' baths seem to be the barometer for how the shift is going?  It doesn't matter what else is going on, if the patient hasn't been bathed yet, it just seems like the day is chaotic and unorganized. 

Patient baths are the marker for what has been or has not been accomplished.  Regardless of what has been done or not been done, patient baths are the indicator of a successful or unsuccessful shift. 

AND, this is equal for night shift and day shift, no matter what the unit's/hospital's policy is about when patients should be bathed.  If we can go to report and say that "at least the bath is done", all is well and we have done our jobs.

Zane Robinson Wolf, in her book Exploring Rituals in Nursing (fascinating book, you really need to read it) says "As nurses lay hands on one to cleanse, comfort, and heal, they accomplish many agendas for patients and themselves.  By virtue of this private work, they implicitly wash away disease and impose order..."

Wednesday, December 18, 2013

Code Armed Intruder

Code Armed Intruder or Code Active Shooter, no matter what it's called, I'm sure it's terrifying for the people working during a hospital shooting.

Thinking of the people in Reno today who had to be a part of that yesterday.  You can read about it here

Tuesday, December 17, 2013

Dangerous Stethoscope

One of my dogs, Ruby, is afraid of my stethoscope.  She doesn't like it when I'm holding it and she stays away from it if it's laying on a table or chair.  She tried to bite the vet when he put the stethoscope on her chest, even had to be muzzled to have her last exam.

I try to tell her that the stethoscope is not dangerous, it can't hurt her.

Then I remember coming in to work to a night nurse holding an incident report for me.

Yes, she had leaned over an elderly patient the night before and her stethoscope had hit the woman in the eye and the poor lady developed quite the shiner.

Maybe Ruby knows more than me.

*eye photo courtesy if wikipedia

Monday, December 16, 2013

The Poetry of Nursing

Every now and then I think I'm going to be a super cool, deep, edgy person who reads poetry and ponders literature over tea at ultra hip coffee shops.

Then I remember that I'm a dork.

I do, however, own a book of poetry called "The Poetry of Nursing: Poems and Commentary of Leading Nurse Poets", edited by Judy Schaefer.

Honestly, it's a little too super cool, edgy, deep, and ultra hip for me.  BUT...

This poem spoke to me - I think we all have that secret place that we stow away the horrible moments we are witness to in our professional lives.

The Secret Life of Nurses - by Veneta Masson

You won't read about it in the tabloids
or inside the gaudy jacket of a Harlequin.
Dear Abby knows nothing about it.
Priests and lovers may think they do
and you
as you glimpse the tips of their shoes
stalled outside a door -
you may think you do,
but you don't.

Nurses keep a safe house hidden
in the spaciousness of imagination --
a dark kiva dug into
the sun-bleached cliff
a gracious ark
gliding high on still waters
a lavender planet idling among far stars.

They keep a safe house
and a fleet of neurons poised for flight.

Friday, December 13, 2013

Soap Opera Nursing

Being at a crossroads in my career, looking for something new, I'm considering Soap Opera Nursing.  I don't really currently watch any daytime soap operas - I follow a few nighttime "dramas" - but my memory of them is that it's a pretty good job. 

Soap opera nurses always look good - perfect fitting uniforms and shoes with a little heel.  They are always holding charts or talking on the phone and they spend most of their time at the nurses station, they are very rarely involved in cleaning poop or lifting patients. Soap opera nurses get a LOT of breaks; they get coffee with friends and meet handsome doctors for lunch in the ritzy hospital cafeteria.  These are definite pluses for this nursing specialty.

I would say that the only downfall with sop opera nursing is that while I would know all about my patients, their families, their friends, and their histories and social lives, I would not be able to identify suspicious characters that want to harm my patients.  They would slip right past me as I'm chatting up a good-looking surgeon at the nurses station.

As well, I believe that soap opera nurses are required to marry doctors and I'm not sure I want to do that, either.

Oh well, back to the drawing board...

*photo courtesy of

Thursday, December 12, 2013

Unleash The Nurses

A few days ago there was an article on Medscape about the political efforts of Terri Mills, a nurse working hard to get a bill passed that would place a nurse at the same level of the Surgeon General for the United States, a nurse who would work with the Surgeon General on national health care issues.

"Unleash The Nurses" is one of the headings and you can read the entire article here.

This is one of my absolute favorite quotes from the article, as stated by Susan Hassmiller of the Robert Wood Johnson Foundation:

"People are looking for solutions for how to deliver better patient care, how to be better providers, what do better systems look like. To not have a nurse at all high-ranking decision-making tables—something's wrong with that picture. You would never make legal decisions without having a lawyer involved, so to make decisions about patient and population care, and not have a nurse at the table is ludicrous."

Amen to that.

*photo courtesy of images.

Wednesday, December 11, 2013

The Gut Is In

Wow - the gut is hot right now, isn't it?  Gut bacteria and depression, gut bacteria and colon cancer, poop pills for C-diff, the diversity of intestinal flora and weight - you can't open a nursing resource right now without reading about it.

For so many years we've been rolling our eyes are those poop-focused patients...have they been right all along?  It figures. 

Monday, December 9, 2013

A Real Nurse's Dream

Whenever we come upon the anniversary of a milestone event, I can't help but think about the nurses involved.  This past weekend we had Pearl Harbor Day, the anniversary of the attack on Pearl Harbor by the Japanese.

There are no surviving nurses from that day but that's no surprise because there were only TWO nurses on duty at Hickam Field hospital that morning at the time of the attack.  Monica Benning was one of those nurses and she died in 2012.  Monica wrote a book titled "A Real Nurse's Dream" about her experience as an Army nurse and of the attack on Pearl Harbor.  Her real life drama was the basis for the movie "Pearl Harbor".

*Photo courtesy of

I don't know if it's true, but one article I read about that day reported that the nurses and other hospital staff on duty that day made arrangements to kill each other if the Japanese were able to take over.  Wow.

Friday, December 6, 2013

"Try and Be Pretty"

The TV show "Julia" was a landmark for nursing.  It was the first TV show about a specific nurse and that nurse was black.  BIG deal in the 1960's.

Here is a clip from Julia's invitation to interview...

As I'm interviewing for new jobs this week, I'm so happy that none of my potential employers have asked me to "try and be pretty"!

Thursday, December 5, 2013

A First For Me...

Let me start by saying this is NOT a political statement.  Please don't freak out.

When I came out of Target last Friday (yes, Black Friday, I admit that I went to Target at 6:00 a.m. - nobody there, by the way, had the place to myself) I looked at the car parked next to mine and saw this bumper sticker.  This was a first for me - I NEVER see nurses with political bumper stickers.  Apologies for the poor photo, people get weird when they see other people taking pictures of their cars so I was trying to be unobtrusive when taking it. 

Nurses have a long history of staying out of politics.  Did you know that even though nursing was a predominantly women's profession in the 1800's (that's an understatement, it was basically ALL a women's profession in the 1800's), nursing refused to get involved in pushing for the women's right to vote?  Yes, a few notable nurses spoke out, but as a group, nursing didn't even take an official stand on the issue.  Unbelievable!

I applaud this nurse for putting it out there, for taking a stand, for making it public - and not just too his/her Facebook friends!

Wednesday, December 4, 2013

Codes, Codes, & More Codes

A hospital I worked for just announced that in order to provide more transparency for patients and visitors, they would no longer be using colors to announce emergency codes - code red for fire, code blue for cardiac arrest, code black for weather emergency, etc.  I guess they will just announce them by name - fire, cardiac arrest, tornado warning, bomb threat, etc.

This is no big deal, it's not like we lied to the patients if they asked what the announcement meant when a color was given over the PA system.  We didn't run around closing doors and if the patient/family asked why we were doing it we didn't yell "IT'S A SECRET" and scoot away to close more doors.  Transparency is the latest overused buzzword for health care, but nurses have always been pretty transparent.  Eliminating the colors for emergency codes?  Sounds good to us, one less thing we have to memorize.

At lunch with a nurse friend the other day, we started discussing this and she told me that her hospital has just implemented a new code - Code Active Shooter.  Wow.

Having worked at two hospitals when there was an active shooter while I was at work, I might have appreciated this code being announced.  This got me thinking about transparency (ugh, I said it again).  It seems like having an active shooter might be one time that using a color would be good - no need to incite pandemonium.  On the other hand, it's probably a good idea to alert staff, patients, visitors that there is an active shooter and they should take cover.

I think the best solution in this situation is to avoid having to use this code by avoiding active shooters in the hospital. 

Monday, December 2, 2013

Hold On, I'm On the Phone!

This week a friend told me that their hospital policy is that employees are not to be talking on their cell phones in the hallways of the hospital.  I can kind of see the point, I guess, that patients and visitors will feel like the employees are not working and even though the employee might be on a break, the patient/visitor won't know that.

On the other hand, what if the employee has a family issue going on and wants to check in while heading to lunch or out the door?  Maybe being in touch by phone is the only way the person felt comfortable coming to work instead of staying home. I'm not sure it's a big deal for the employee to make a quick call.

What do you think about nurses carrying cell phones in their pockets?  I doubt that there are many institutions that encourage this practice, I bet most have policies against it.  Yet, I know that many, many nurses carry their cell phones in their pockets during work.

I have mixed feelings.  I really do not like it when I'm running around like crazy and another nurse is sitting at the nurses station surfing and texting on her cell phone.  However, I don't think the phone is really the problem; she probably wouldn't be helping out regardless if she had it with her or not.

When I worked at a rural hospital and there were only two nurses in the whole place at night or on the weekend, I thought it was a good idea for the nurses to have their cell phones on them.  If something bad happened like a fire, weather emergency, an intruder, or they simply had to be in different parts of the hospital, having a cell phone in hand would allow them to call for outside help or just call each other quickly.

I remember when hospital computers were not allowed access to the Internet because it was felt that employees would just sit around and surf.  Then hospital leaders realized that there's good stuff on the Internet that can be helpful in caring for patients.  I think it's kind of the same thing with cell phones.  Instead of continuing to "ban" them, we will have to figure out how to use them appropriately in patient care areas.  Like the Internet, cell phones have some use in patient care.  Calculators, apps for smartphones that provide drug information, and a camera because has anyone actually seen that camera the manager bought for the unit since the day after she got it?

Friday, November 29, 2013

Louisa May Alcott

One of my all time favorite books is "Little Women" written by Louisa May Alcott and while she's long dead, today is the anniversary of her birth.

Louisa May Alcott was also a nurse and served on the Union side during the Civil War.  She was active in fighting for the woman's right to vote (a fight that nursing was decidedly NOT generally involved in) and in the temperance movement (we'll have to forgive her that).

Louisa May Alcott (it's hard to say her name without saying the whole thing) published a book of her diary during the Civil War.

While I admit that I do have the book, it is challenging to read and not terribly interesting...Sorry Louisa (Louisa May?)

Happy Birthday Louisa May!

Thursday, November 28, 2013

This Thanksgiving

I am thankful for all of the nurses working last night, today, and tonight because I know that their holiday is not so great and I know that there are patients and families who are SO appreciative of their presence.

Southlake Village

Specifically, I'm grateful for the staff at Southlake Village in Lincoln, Nebraska because my mom is a patient there right now.  And, I'm grateful for the nursing staff at the Nebraska Heart Hospital; I miss them very much.

Happy Thanksgiving!

Wednesday, November 27, 2013

Code Happy

Do you remember the scene in Legally Blonde 2:  Red, White, and Blonde (yes, I know, not even close to as good as the original Legally Blonde, but don't tell me you didn't go see it) near the end of the movie where Elle makes the call and activates her sorority girl network on their equivalent of the bat phone?

Nurses can do that, too:

It's the Code Happy app! Our own little nursing support network.  You can get or give instant support with a tap on your phone.  My favorite happygram?  "I'm sending you garlic and a cross!"  I think we've all been there...

If you're a Code Happy nurse, look me up.  I'm Nurse Turpel and I'll send you a happygram - or garlic and a cross, whatever.

Tuesday, November 26, 2013

Don't I Know You?

I grew up in small towns; I lived in small towns through my high school graduation.  Everybody knows everybody in small towns.  Above is a street corner in one of my "home towns".  I lived there when that mural was first painted.

After nursing school, I moved to Southern California and started my nursing career.  From Los Angeles to Miami, I only worked as a nurse in big cities - nobody knows anybody in big cites. 

So...I never had patients that I knew before they needed nursing care.  All my patients started out as strangers to me.

A few years ago I relocated to rural Nebraska and worked in a small community hospital.  Same small town I graduated high school in.  The nurses I worked with took it for granted that their patients would be people they'd known before, maybe even for their whole lives.  They were used to it.  I wasn't.

Having to get one of my former teachers off the commode, putting a foley in my one of my parents' friends, talking to former classmates about their personal health issues, it bothered me. 

I know that for some of the patients it was embarrassing.  I know this because they would tell me.  For others, it seemed comforting to have a nurse they knew before.  I never really got used to it. 

Now I'm back in the city and one perk is that my patients probably won't be my neighbors. 

Do you like taking care of your neighbors and friends?  Am I the only one who doesn't?

Here's my new neighborhood - nice, huh?

Monday, November 25, 2013

JFK's ED Nurses

All of the stories on the news about the 50th anniversary of the assassination of President Kennedy and his pronouncement of death has made me think about the nurses who might have been present in the ED at Parkland Hospital that day in Dallas.

Presumably, there aren't many of them still alive.  Here's a link to a you-tube video of one of them:

And an article:


Are these truthful?  I guess there's no way of knowing.

We do know one thing.  When it came time to clean up, everyone was gone but the nurses.

Friday, November 22, 2013

Seeking a Cap

That's me on the left.  That's Lori on the right - I'm totally putting this picture here without her permission.  She looks great; why would she mind?

Sorry about the picture quality - it's a photo of a photo that was likely taken with a 110 camera (and the photo has been sitting in a box for a "few" years).  Remember those?  I have no idea why the shadow over me...can't get rid of it though. 

I graduated from nursing school in a cap.  Yes, we still called it nursing school and yes, I had a cap.  I believe we were "capped" after our first year clinical experience and then we had to wear our caps for every clinical rotation except for the ICU rotation.  Does anyone remember why that was - why we didn't wear them for our ICU rotation?

Anyway, I can't find my cap.  It's been missing for years.  I REALLY wish I still had it.  I've checked ebay and etsy repeatedly but no caps from Bishop Clarkson School of Nursing (believe it was College of Nursing) by the time I graduated, but no luck.

So...if anyone out there has a cap from Bishop Clarkson School of Nursing in Omaha, Nebraska and wants to sell it, I'm interested! 

Thursday, November 21, 2013

Do You Know Flo?

What do you know about Florence Nightingale?  She went to the Crimean War, she invented nursing, she had a lamp, it was all too much for her and she returned from the war and fell into her bed from exhaustion and then died.  Right?

Would you believe that all of her work was such an embarrassment to her family that they destroyed many of her personal documents and had a biographer write a fake biography about her? 

I'm sure many of our families would like to have this option!

The first biography of Florence showed her as heroine from the Crimean War who was so consumed by this passion that she came home from the war and took too her bed, suffering from something called "neurasthenia".  Neurasthenia was a disease that occurred only in women in Victorian times and was caused by trying to work too hard  (I knew there was a reason not to work so hard!). 

You can kind of see why her parents did this.  Florence first upset her parents by asking to learn, at the age of 20, about mathematics!  Gasp!  Of all things.  She was 20 years old and had no prospects of marriage so they figured she was a waste anyway, she might as well go ahead and learn some math.  Then, she had the audacity to tell her mother, repeatedly, that what she really wanted to do with her life was run a hospital.  Every time she told her mother this,  her mother got the vapors and collapsed in shock.*  Apparently in the 1800's, running a hospital was the equivalent of getting a nose ring. 

Actually, Florence came back to England at the age of 36 from the Crimean War and worked until her death at age 90 to improve health through sanitary conditions.  She was quite the activist, though not without controversy. 

More to come...

*From Hugh Small's book, Florence Nightingale, Avenging Angel, 2nd ed., Knowledge Leak, London.

Wednesday, November 20, 2013

Calling All Nurse Dorks

Those of you who know me, know I'm a dork.  I get called a dork at least once a day.  Mostly by my husband, but also by my other family members and by friends.  ALL of the nurses I have ever worked with have thought or said "what a dork" about me at one time or another. 

Most of my dorkiness comes from my odd interest in the culture of nursing.  The language, the gestures, the understanding, and the rituals are fascinating to me. 

I recently discovered Zane Robinson Wolf and her books.  The one above is, I believe, no longer being printed, but I found a used copy.  It's from 1988 - doesn't seem that long ago to me, but I guess it is.  This book is based on her doctoral dissertation and is an observation of one nursing unit over time.  It reads a little like a soap opera.  I was starting my first hospital job as an RN around the time the observations were made, so I could totally relate to it.

Zane contends that nursing within hospitals is a "quasi-religion" and identifies rituals sacred to nursing but which occur in the most profane manner.  Que harp music and angels singing - I found the mother ship! 

One of the rituals Zane discusses is that of post-mortem care.  In the book, she shares this photo:

It's from an old shroud kit and I totally remember these.  We used to have to tie the hands and feet together and put a chin strap on the body before closing the shroud.  Why did we do that?  Does anyone still do that?  The last hospital I worked at didn't even have shrouds (I don't think, I never saw any). 

Fascinating book.  Mandatory reading for nurse dorks.

Monday, November 18, 2013

Thinking of Our Filipino Friends

One of my first RN jobs was working nights at a children's hospital in Los Angeles.  I was the only non-Filipino nurse on the night shift.  I frequently tell people I was raised by Filipino nurses.  They taught me so much and fed me so well!  I was new to Los Angeles from small-town Nebraska so my knowledge of other cultures was limited and they put up with a lot while they educated me.

There are so many nurses from the Philippines working in the United States.  Recently, a classmate of mine from the Philippines told me that it is also not uncommon for Filipino physicians to come to the US and take the RN boards because being a nurse here is so much better than being a doctor there. 

We feel horrible when we see the devastation that disasters bring to ANY area.  However, among nurses there are so many of our friends and colleagues from the Philippines that it is extra hard to watch what is happening in their country. 

The American Nurses Association has a foundation that provides disaster relief and they are accepting donations to assist in the Philippines.  If you are so inclined, you can find them here.  Money isn't everything.  We can also send our prayers and our positive thoughts and, as always, a kind word to our Filipino nurse friends.

Friday, November 15, 2013

Worked to Death reported a story a couple of days ago about a man suing the hospital where is wife, a nurse, worked prior to her death.  She was killed driving home after a 12-hour shift; you can see the whole store here.  I'm very much against unions for nurses and against mandated staffing ratios and don't think that the article should have been used as an opportunity to push that agenda.  Mandated ratios wouldn't have prevented this nurse's death.

However, could her death have been prevented by someone taking her stress and complaints seriously?  Should the hospital or her co-workers have said wait - you can't work anymore?  It makes me wonder how many times I have seen nurse colleagues working tons of hours and I can see how it's taking it's toll and we just keep letting them come into work.

The real issue is not how many patients we take care of, the issue is how many hours we can safely work.

Wednesday, November 13, 2013

Nothing to Talk About?

I love Jessie Knadler's blog "Rurally Screwed"; I read it every day.  This week she posted on 7 Things Never to Talk About.  You can read it here.  As I was reading the post, I thought "well then what the hell would nurses talk to each other about?"  Maybe we shouldn't talk to other people about how we slept, our aches and pains, or our periods, but we NEED to talk to each other about that stuff.

Why else go to work?

Monday, November 11, 2013

I Love the Nursing Shortage

I hope the nursing shortage never goes away.  This is not a popular opinion, I know.  When I talk about this with my students or with my classmates, it sparks quite a bit of discussion - most of it in direct opposition of this controversial opinion. 

I like being a commodity, I think it's great that we're in high demand. 

Are there bad things about the nursing shortage?  Sure. 

One of my classmates says I'm nuts because if there aren't enough nurses, unlicensed assistive personnel will take over our jobs.  To that I have to say that I think we get caught up in doing too many tasks that we could delegate to others anyway.  We should focus on educating patients, assessing patients, managing their care across a continuum.  We definitely need to get better at delegating, though.

One of my students says I'm nuts because she where she works the staffing is horrendous and it will only get better if the nursing shortage ends.  To that I have to say that we do have a nursing shortage and that many places have great staffing.  She works in a place that doesn't value nursing and won't staff well no matter how many nurses there are. 

In the meantime, since I'm looking for a job (I'm going to, I really am) I'm happy there's a nursing shortage and I hope there always will be.

Friday, November 8, 2013

Spoiled by Great Nursing

Because of my move, I'm looking for a new job.  I teach online part time and I enjoy that, but it's an adjunct faculty position with no benefits or guaranteed classes so I'm looking for a new position.

Yesterday, a company that conducts post-employment interviews for the organization I just left called me and I had a chance to reflect upon my experience there. 

The hospital I just left practices the Universal Bed Model and while I was not familiar with the concept until I started working there, I'm a total convert now.  The patient-centered care approach that the Universal Bed Model provides is really good for patients.  Having care come to the patient instead of the patient going to various places for care is a great concept. 

When I talked to one potential employer about this concept, she asked "why don't we all do it like that?"

While I'm sure I'll find a great place to work where the nurses take pride in providing the highest quality care, I'm a bit spoiled now by the way my former employer provided care.

Tuesday, November 5, 2013

My Other Family

"Ten minutes after you're out the door, they forget all about you anyway."

This is what I've been known to tell my friends and colleagues who are letting work get the best of them and who are sacrificing their personal lives for the job. 

Having just left a job, I really hope they wait more than ten minutes to forget about me. 

It's hard to say good bye to our work family.  They really are a family.  I wonder if those in other professions really get as close to their colleagues as nurses do.  I think part of the reason that we get so close so fast is that we work in close proximity to each other and we have to create teamwork quickly and in very high-stress situations.  How many nurses have you bonded with over a code?  I bet there's a few. 

At least we have social media now.  I'll get to see photos of the babies born, houses built, and engagement/weddings of the nurses I just left.  It's not the same, though.  I like the day-to-day, hearing about their weekend, what their kids did, how their last day of work went. 

I'm moving across country from my actual family and that's been hard.  Leaving my other family, my work family, is hard, too.  I miss you guys already.

Saturday, November 2, 2013

Shiny Scrubs

Several years ago, I made a comment to a co-worker that it might be time for a new pair of scrub pants as hers were so worn that they were basically transparent.  "I know," she said, "but I LOVE these pants. They're my favorite pair.  I just can't get rid of them." 

Well-worn scrubs takes on that shiny look, don't they?  They lose the cottony stiffness and get soft and pliable.  Comfortable. 

I've never let my scrubs get to that point, but I know a lot of you do.

We have our favorite "under scrubs" shirts, too.  This is obviously one of them:

If you ask him about getting a new shirt to wear under his scrubs, he says "hey!  this is just getting broken in!"

Another nurse I know has stapled the worn elbow holes of her scrub jacket closed.

Comfortable..or are we just cheap?

Thursday, October 31, 2013

Pen Love

We do have a rather strong attachment to pens, don't we?  Or is it just me?  I don't think so. After all, I've given report to you with your pens lined up like little soldiers next to you, I've seen your work bag overflowing with pens.

Some nurses like to have a lot of different pens with them at work, different colors and different types - ink pen, mechanical pencil, highlighter, Sharpie.  (Don't even get me started on Sharpies - my attachment to Sharpies is so unhealthy that I hoard them in a drawer at home, won't even take them to work).

I'm more of a one-pen-at-a-time nurse at work, but I protect that pen with my life while I have it.  I won't even let patients touch my pen to sign anything, I take them one of those generic pens from the nurses station. 

We even talk about pens, don't we?  "Hey - that's a great pen!  Where did you get it?"  We discuss and debate the merits of fine point over medium point (I'm a medium point nurse myself).  Yep, pens are a part of our nursing culture.

 Nurses and pens, a match made in heaven.

Tuesday, October 29, 2013

The Miracle of Movement

I continue to be amazed at the power of mobility for patients.  There has been a lot of talk in the journals lately about early mobilization for critically ill patients, it's becoming the standard of care in ICUs.

One of my cousins had emergency major abdominal surgery several months ago and her mom, my aunt, wrote in an email to the family that she was shocked and concerned that the nurses wanted my cousin to get up and walk when she was obviously in horrible pain and just had emergency surgery and could we believe that?  Yes, I could believe it - and wasn't my cousin lucky that she had nurses who know about the power of moving.

I'm a recent convert to the mobility miracle.  But, I'm a believer now because I've seen it work.  Patients have less pain, they sleep better, and they get back to their lives faster when they get up to walk.  Walk early, walk often. 

I asked a co-worker about why getting out of bed right away after heart surgery seems to help these patients so much and she said it's because "they realize they're alive".  I agree with that, but I also think that getting out of bed shakes everything back into position.  We're not meant to be lying down, we're meant to be upright (shoot, I know, lying down is soooo much more fun).  Our innards get all messed up when we stay in bed too long, we have to jostle them back to their rightful place.

Bodies in motion stay in motion, right? 

Sunday, October 27, 2013

When It's Someone We Know and Love...

As nurses, when we have a family member in the hospital, it is very comforting to know that the nurse caring for them is someone we know.  I know this because a very good friend had a family member in this hospital this week under the saddest and worst of circumstances and she was so comforted by the fact that the assigned nurses were long time friends and co-workers.

For the nurses caring for the patient, it is another story.  When the outcome is not good, when the circumstances are sad and complicated, it makes a challenging situation so much more so.  I know this because I saw it in the nurses' eyes.  When I commented that I appreciated how hard it was for these nurses, I saw tears and pain.  It was impossible for the nurses to protect themselves, they were involved in the pain and sadness. 

We are supposed to have empathy, to express our caring but also maintain professional distance.  When it's someone we know and love, when we know our friend and co-worker is going to experience a horrible loss, that all goes out the window. 

Wednesday, October 23, 2013

Everybody Needs A Nurse

I've heard it said that every woman needs a wife and I'm pretty sure that's true (sorry guys, but it's true that being the husband is the easy my next life, I want to be the husband).  But, wouldn't it be great if we all had our own nurse?  

Someone to handle things, coordinate healthcare, review medications, intervene to catch near-misses, and listen? I could get on board with that.

It's 2013 and patients still don't understand that it's not their doctor that gets them better, it's their nurse.  I'm not knocking doctors, mind you, but I think we all know that if health care was left to the docs there would be a lot of orders and not much actual care.  Especially in the hospital.  If all patients needed was a doctor, they could just go to the office.  Patients come to hospitals because they need nurses.

Yet, nursing care is still included in the room and board charge for hospitals.  Why is this?  Here's my theory on that:

Have you ever seen those reports that come out every now and then and try to put a value on the work of a stay-at-home parent?  The numbers are always astronomical and it's clear that nobody could ever actually afford to pay a stay-at-home parent what they are worth.   I think it's the same with nurses.  Our work is included in the room-and-board charge because nobody would ever actually be able to pay us for our true worth.  

That being said, I wish I could afford a nurse.  Everybody needs their own nurse.

Tuesday, October 22, 2013

The Vein Dance

Today a co-worker asked me to start an IV for her.  She had tried once and another nurse had tried twice.  I got lucky an got the IV. What a great feeling!!

It won't last. 

Tomorrow I'll be asking someone to start an IV for me after I've missed twice.  That's the way it is with IVs.  Some days you can't hit a vein with flashing arrows and a sign that says "stick here"; some days you you can put a catheter in a rock with your eyes closed.

Don't you wish patients understood this?  Don't you love it when they suggest that you go get the doctor to start their IV?  Don't you love it when they tell you that the phlebotomist had no problem getting a vein yesterday? 


Oh well, today I was the IV starting equivalent of the windshield.  Tomorrow, I'll be the bug.

Saturday, October 19, 2013

Here In The Real World

Reality Shock is what happens when new graduate nurses enter professional practice for the first time and realize that it has absolutely nothing to do with what they learned in school.  I remember it well, even though I've been out of school a long (long, long) time.  I remember my preceptor, Cindy, standing next to me and telling me that I'd better hurry and put the blood I'd just drawn from a heparin lock (that's how long ago it was, we had heparin locks) into the tube before it clotted.  I must have looked like an idiot because I was thinking:  what tube?  how do I get it in there?  what happens if it clots?  you can draw blood from a heparin lock? WHY DIDN'T THEY TEACH US THIS STUFF IN SCHOOL???  I had no idea what I was doing and I was experiencing a serious case of Reality Shock. 

I also remember the first day things came together for me.  The six to eight months in between these two days are mostly a blur with tiny little vivid moments of terror. 

Awhile ago I watched a new nurse trying so hard to do assessments the way he learned in school, the long way, while his preceptor explained that doing them that way won't work if he ever wants to finish.  And he may not have cared at that moment if he ever actually finished, but she's been a nurse for awhile and she definitely wants to get done.

It's not the new nurses fault, it's nobody's fault, it's just the way it is.  The problem is that it's virtually impossible in nursing school to actually explain how it's going to be after nursing school.  Nurse educators have to teach things the way they would be in a perfect world.  Unfortunately, as nurses, we work in the real world. 

Thursday, October 17, 2013

The Nursing Freak Show

Once at a carnival, I paid 25 cents to see a headless woman.  Yes, I was an adult at the time. No, I'm not proud of it. I paid my quarter and went up a set of steps to stand on a platform which looked into a space where a "woman" sat in a rocking chair moving her hands while a supposed ventilator breathed for her through a metal cap on her neck where her head, if she'd had one, would have been.  

It was lame.  Like I said, not my proudest moment.  

This got me thinking that as nurses, we could probably put on our own show at a carnival.  You know, charge money to see some of our "oddities".  


The world's largest bladder.
The world's largest collection of alcohol wipes.
The world's largest pen collection.
The world's sickest humor.
The world’s fastest eater.

Step right up, folks!  It’s our own little nursing freak show!  Can you think of more?