Brie Gowen

Savor the Essence of Life

3 Things That Make Me Absolutely Adore Annual, Computer Based Learning

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I can’t believe it’s been another year! That’s right, folks. Another year as a hospital employee has rolled around, and as my special anniversary comes up I am rewarded with the honor of completing my annually required CBLs. It’s basically like getting a cake and almost as good as a raise. 

I personally consider CBLs to rank right up there with mandatory, fifteen minute meetings on my list of all-time faves. I enjoy completing them so much that I really had a difficult time compiling all the things I love about them in one concise list, but I suppose if I had to narrow it down to three things that make me absolutely adore annual, computer based learning then these would make the cut. 

1. They’re always pertinent. 

I find that the information contained in CBL modules always relates well with my current job. After all, I think most nurses would agree that being cognizant of what year the first hip replacement was performed is detrimental to good patient care delivery. Plus it’s really important to know what exactly a Thebesian Vein is, and where to find Erb’s point. Subsequently it’s not a Shakespearean actor performing at Globe’s Theatre. 

It’s not easy cramming so much useless information into a sandwich of content useful for the job, but CBLs manage to bring it home. What nurse could perform their duties correctly without being reminded yearly not to plug in an appliance with a frayed electrical cord that you brought from home? And who doesn’t need reinforcement of Erickson’s psychological stages of development? Of note, don’t try and tell a toddler to do something exactly like you do it as an adult. Apparently that doesn’t work. I’ll keep this in mind when visitors under twelve enter my critical care unit. 

2. The content is consistent in nature and relevant to my knowledge and skill level. 

This is probably my favorite. The great thing about CBL tests is that they are consistently consistent. What I mean is that you never end up taking one test with obviously asinine questions that could be answered correctly by my four year old then turn around and take another test that couldn’t be passed by Einstein or Stephen Hawking. 

It’s true. It’s not like the questions are obviously, painstakingly gathered to meet an educational requirement. You never have to worry about taking a test with preschool level “don’t take a cookie without asking” type questions, and then right afterwards take a test five times in a row to make a 100 on the questions that are based on medical school equivalent curriculum. Man, if that were the case I would probably want to drive an ice pick through my skull. Repeatedly. 


3. I never procrastinate. 

Since I enjoy the content of the learning modules so much I always finish them early. I can often be seen at the beginning of the year camped out in front of a work computer, salivating in anticipation of completing my annually required training. 

I tell you what I don’t do. I never wait until two weeks before they’re due to complete all 837 modules at once. If that were the case I probably wouldn’t even have time to complete the required courses, and I’d just end up taking the tests on the fly, hoping that when I failed the correct answers would be provided at the end for my next go-round. Glad I don’t do that. That would probably induce another ice pick in the brain desire. 

I did happen to save a few until the end, though, just to prolong the pleasure. And as I completed the last one today I’m sure my emotional release could be heard across the globe. Indeed racking sobs of grief over being unable to read about HIPPA regulations for the rest of the year escaped me in a huge wave. I’m certain they were tears of sadness; certainly not those of joyful relief. 

30 Truths Your Nurse Wants You to Know

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1. We like what we do, but sometimes we complain because a lot of people are just total jerks. 

2. We have the biggest bladders known to man. 

3. On a 0-10 pain scale, 10 would imply it’s the absolute worse pain you’ve ever had in your whole life. (Like a rogue bear just ripped your arm off.)

4. We could probably diagnose you based on what your poop smells like. 

5. Subsequently, nurses can’t “diagnose.” It’s not that we want to keep secrets; it’s the law. 

6. We go home, and still smell pee. 

7.  We hate the beep of the IV pump as much as you do. Probably more. 

8. We’re not waitresses, baby-sitters, or family counsellors. The hospital is not the set of the Jerry Springer show.

9. We want to hit the vein the first time just as much as you want us to. 

10. It’s not that we couldn’t be a doctor; we didn’t want to. 

11. You’re not our only patient. Wish you were. 

12. Nobody likes to clean up poop, but we do it for the patient because we care. 

13. Cleaning up poop isn’t all we do. 

14. Speaking of poop; no one’s health has been negatively impacted by not pooping every day. 

15. You’d be surprised how much we have to know to not accidentally kill you. Like, it’s crazy. 

16. Antibiotics are useless for viral infections such as the common cold. 

17. We like to eat lunch. Sometimes we get to. 

18. We are unable to read your doctor’s mind. We can get really close, but the second we tell you “blue” they’ll say “red.” So don’t ask us to try. 

19. Most of us have lost someone too. We get it. 

20. We don’t make as much money as you think. 

21. We joke around as a means of coping with stress, anxiety, or grief. 

22. We believe what you tell us, but medtox lab results don’t lie. Just saying. 

23. Just gonna leave this here. 

This is the definition of allergic reaction: A drug allergy is the abnormal reaction of your immune system to a medication. The most common signs and symptoms of drug allergy are hives, rash or fever. A drug allergy is not the same as drug side effects, such as constipation or drowsiness. 

24. “I can’t breathe” would imply you cannot talk or maintain consciousness. If you cannot breathe I will stick a tube down your throat to breathe for you. 

25. Everyone has a temperature. If you do not you are deceased. 

26. An elevated temperature is called a fever. This is a natural mechanism to fight illness. 

27. Yep, we don’t usually have to work five days a week. We’re so lucky. Instead we work a string of grueling, exhausting thirteen hours days. We also work most holidays with little to no compensation for the fact. 

28. Going to the ER (Emergency Room) suggests you have an emergency. Emergencies require immediate assistance or you may die. Refills, colds, or any rash without an interference of breathing (see above for “can’t breathe) are not typically considered emergencies. 

29. We like breaks. Sometimes we get to take them. Please understand. 

30. But above all, we love being a nurse!

 

I’m a Nervous Nurse

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I sat counting his respirations, and when I didn’t like what I got, I started over and I counted again. I counted a full minute. My patient slept soundly, and his oxygen saturation wasn’t just within normal limits; it was good. He was good, so it seemed, but still I watched almost nervously. I watched his monitors ready for any change I saw. 

Sometimes I had feelings, you know? They were like an itch under the skin, the ones where no cause of irritation is seen, but that urge to scratch presents itself nonetheless. Sometimes I felt that way about my patients. Sometimes I felt like under the surface something awful lurked just waiting to pounce unannounced, and in my nervous anticipation I would be keenly aware of any minute change. 

I had let him sleep as much as I dared. He woke, although sluggishly, and answered my questions appropriately. His respiratory rate remained stable, and so too did his other vital signs. His lungs were essentially clear, and no problems were observed with his chest tube, or his other body systems for that matter. He was fine. He was fine and dandy, and later as I watched him conversing with family I wondered if perhaps I worried too much. 

It seems I’m wired that way. I’m a nervous nurse, and when all seems well I still keep watch. And especially when a voice inside my head silently urges “watch,” that is what I do. I watch, I wait, and I run through possible scenarios of negative outcomes that might come my way. 

I’ve been in the medical field for eighteen years, and I’ve been an RN for eleven, but no amount of experience and time can ever take away my tense state of mind when someone’s life is on the line. Time has softened the edges of my anxiety, and experience has given me the calm, collected demeanor of a professional even in the face of a hot mess. After all, I’m certainly not the shaking, fearful girl I was my first year out of nursing school, but I’ll be honest. I still get scared sometimes, and occasionally I still shake before my extremely sick patient arrives. So despite the improvements of my clarity over the past decade, I still get nervous. 

Sometimes my nerves prove negligible, and my patient sails smoothly through our time together. But sometimes I wonder if their outcome would have been as positive had I not been so diligent and watchful. I may never know. What I do know is that often times patients crash despite your rapt attention, and there’s nothing you can do. But I try not to give them the opportunity. 

So I stay on edge. I don’t get relaxed, and even if I look like I am, I’m usually not. Instead I’m nervous. It may not be a panicky, wringing hands kind of concern, but it’s always an observant, expectant mode of operation. 

Sometimes I wish I wasn’t a nervous nurse. I watch so many of my peers that I respect and admire. Some get excited at the thrill of chaos, and others seem almost unfazed by out-of-control scenarios that later cause me to question my abilities as a nursing professional. I see their nonchalant approach, and I secretly wish I could be so unconcerned, or rather unaffected. 

But instead I’m a nervous nurse. I suppose I always will be. I don’t stray far from my patient’s bedside. I double-check things, and I persist at assessment of unchanging systems. Just in case. I listen. I listen to my patient, and I listen to the voice inside my head. And I remain nervous. 

How to Retain Nurses in Your Area

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On my particular unit where I work I’ve recently noticed an outflux of staff. Many are leaving to pursue academic advancement, and others are seeking additional opportunities. It happens; especially in nursing. 

I have been in my particular area for some time, and every 2-3 years I see a gentle rise in staff leaving. It’s always a bit frightening to see them go, and you wonder, will this cause patient care to suffer? After all, that’s who’s really affected by the issue of nursing retention. The patient. But thankfully, as history has shown, new staff come to fill the empty slots, and the machine of healthcare continues to chug along. Yet I wonder, what if it didn’t? What if it couldn’t?

In my specific circumstances it’s no definitive fault of the unit or the organization that causes staff to leave, but it does make one think. What can we do to retain nurses? It’s not any one individual’s responsibility, but rather the job of us all to keep staff happy. Together maybe we can help lessen the staff shortages in our area. 

So how do we do that?

Pay. Increase it. 

There. That’s it. End of blog. Thanks for reading along. 

No, seriously, I mention pay first because it’s important, and though it’s certainly not the reason that nurses nurse it is a deciding factor in where they work. 

If a nurse can travel a little over an hour away and make a considerably higher paycheck then they will likely do so. The issue of pay is a problem in rural areas. Hospitals don’t have to compete as much in these smaller towns, but when nurses see the pay of their counterparts 45 miles away they honestly become jaded. The grass (paycheck) truly becomes greener. 

I’ve worked at hospitals that offer sign-on bonuses, competitive pay, and other monetary incentives, such as money for furthering your education. It helps, and it makes a nurse feel appreciated. 

Perhaps pay scales should also reflect the area where you work. Pay incentives could be offered for areas where your skill level, stress level, and level of critical thinking is higher. And perhaps a nurse who stands on their feet for thirteen hours should make more than one who sits at a desk for eight, not vice versa. 

Incentives are a good way to maintain retention. Aside from the fact that I love my hospital organization and my unit, I remain here due to the incentive of my particular schedule. I’m supremely blessed with it, and this schedule offered to me allows me to make a living and care for my young children, and that’s important to me. We should do this more. 

Self-scheduling, clinical ladders, on-site daycare, and many other incentives that allow a nurse to know that they are valued and their personal life is important to the employer; this is what keeps staff happy. 

And so does staffing adequately. It’s a must. I know this seems like a catch-22. How can I staff adequately if I don’t have the staff?! Well, I personally believe, as a frontline nurse, that when placed in an overworked, possibly unsafe environment you don’t want to stay. I mean, who wants to pull double the load? No one. 

If we can build a strong, core staff, and keep them happy, they will stay. Then the key is to staff adequately so nurses don’t feel overwhelmed and under-appreciated. This is no easy task, but once an appropriate ratio of staff is obtained it should be utilized. Payroll is important to an organization’s longevity and profit, but in the long run more funds are used to repeatedly train new staff than could have been spent to pay the ones you once had but lost due to stress and exhaustion. Does this make sense?

No one needs overtime every week. Weekends off are a great thing, and this is where the incentive of weekender positions benefit everyone. They are costly, but again, it costs less in the long run if you can retain your staff. Staff builders or outside staffing agencies to supplement areas are a beautiful thing. Having a pocket of dependable prn personnel is important also. 

No nurse wants to hear phrases like “suck it up” or “put on your big girl panties.” To me, I just hear, “your comfortability isn’t a priority to me.” Lawsuits are real, and no one wants to be a part of one due to unrealistic work environments. 

Charge nurses can’t be expected to take a full load of very ill patients just like the other staff nurses, but then be held responsible if something goes terribly wrong on their watch. And then only get a quarter extra for their troubles. 

And teamwork goes a long way on a busy unit, but that only carries you so far. After nothing but bad days a nurse can get burnt out. 

It’s also important to create a motivating environment for the staff you have. Nurses love nursing. It’s why they went into the field, and what keeps them in it. Nurses love knowledge, and they enjoy the opportunity to learn new things. If new nurses are being oriented to a rotation that sits around on their phone they’re gonna wonder what they’re doing there. 

New staff needs continued motivation that they are learning more and more. They need to feel like what they’re learning is needed for patient care. Preceptors need to be selected carefully, and they need to have the ability to excite and motivate new staff. Just because someone has been around a while doesn’t mean they need to be the trainers. You might be perpetuating an attitude of dissatisfaction. One bad apple ruins the barrel. 

I recall having a CEO once who met with staff regularly, and he showed them how their actions were changing the culture to positively impact patient care. His words motivated his people, and I was excited to be a part of his organization. People thrive on team-building. 

Create excitement over what staff contribute. Make sure they know their actions are saving lives, making a difference, and an integral part to the team. A “thank you” and “job well done” can carry a stressed out staff member even beyond what a 2% raise may do, but don’t quote me on that. We still want the raise. 

In that same vein of thinking it’s important to empathize with your staff. You never want to rise so high up the corporate ladder that you forget from whence you came. That’s why it’s important to remind yourselves of what it’s like in your staff’s shoes. Come out on the floor and get your hands dirty. Often. 

When the feces rolls downhill, and problems must be addressed, try to place yourself in the position of your nurses prior to the wording of your hasty emails/memos or irrational rants. Try and remember what it’s like to be in the thick of patient care, and remember how to be realistic. Unrealistic expectations will always lead to disgruntled nursing staff. 

Try to whittle down to what’s important. Just like with being a parent, as a leader you must pick your battles. What ranks top with you? Is it quality, safe patient care or perfect restraint documentation? Are you placing too much emphasis on patient satisfaction surveys in the face of extremely dissatisfied staff? Just a thought. 

On a personal level, I know my unit will come out on top. It’s a great place to work, and we’ll pull together and rise out of the ashes as we’ve always done. But it never hurts to realign our thinking towards improved retention. We can always improve our hiring processes and utilization of present staff. 

As I said before, retention is no one person’s responsibility. It falls on all our shoulders. Our ability to retain, train, and excite the next generation of nurses is detrimental to continued, great patient care. One day we’ll be patients, and we’ll desire a dedicated healthcare team for ourselves and our family. And if that thought isn’t motivating, then I don’t know what is. 

 

What I Thought When My Daughter Said She Wanted to Be a Nurse

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This morning when I woke I realized that I had been dreaming about work all night, and I already felt worn out about the idea of completing a thirteen hour shift at the hospital after nursing in my sleep for the past six. That’s the thing about being a nurse. It’s all consuming; it’s not just a job. 

And it was this knowledge that persisted when my daughter said she wanted to be one too. She’s only four, mind you, but she’s started becoming interested in things that interest me, and I wasn’t very surprised when she cuddled up under my arm to watch a medical show with me this past week. 

Mystery Diagnosis, one of my faves, played across the flat screen, and rather than the Disney movie that held her little sister’s interest, my almost-kindergartener wanted to watch along with me. I let her watch the less gruesome shows, and she actually seemed to like them. 

“I love these medical shows, Mom.” She stated with glee. But then she caught me off guard by adding, “When I grow up I want to be a nurse like you!” 

I was honored, for sure, yet I was also hesitant. But instead of sharing the multiple thoughts that bombarded me at the time, I just kept them to myself, and I said, “You can be anything you want to be, baby.”

See, the thing was I knew more than she did. Naturally. She was just four as previously stated, but it was more than that. I knew what being a nurse meant. 

Being a nurse meant more than just a job. It was a lifestyle, a vocation, a calling, and one that once held turned the individual upside down. 

As a nurse I was connected with my patients through my care. I knew them intimately, I cared for their physical and emotional, and even when I left the bedside they were still on my mind. There was no leaving your work at work. Not really. I had tried. 

I understood that once you became a nurse the way you viewed life changed. You no longer took health for granted, you appreciated life, family, and time spent with those who made you smile. You had seen things you couldn’t unsee, horrors that changed your perspective. 

You couldn’t look at bulging veins on a stranger’s arm and not imagine cannulating them anymore than you could ignore keeping an eye on your spouse’s blood pressure and cholesterol. You couldn’t drive by an accident without feeling like you should stop, and when children played haphazardly outside you stood ready to intervene if necessary. A nurse knows they’re never really off duty. 

In nursing you dreamed about it, you worried about it. It wasn’t just something you did, but rather who you were. 

My little girl saw cool gadgets and excitement on the television screen. I saw a mother crying in the background, not sure if her son would pull through the traumatic accident. 

My daughter saw a job she respected, and I saw a profession I gave my heart and soul. She didn’t know I prayed for strength before each shift, or that I often cried in frustration over the parts of it that I was powerless to change. 

I knew that being a nurse meant stretching yourself physically, mentally, and emotionally to the point of breaking. And then stretching some more. 

I knew the occupational hazards the field contained, the physical hardships it entailed, and the emotional stress that a nurse carried every day. I knew these things, and I worried for her. I wasn’t sure I wanted my baby to experience any of that!

Yesterday I was on the phone with a military bank I use that also specializes in assisting veterans. As I spoke to a woman and gave her some personal information, such as occupation, she interrupted me saying, “Thank you for your service. I mean, thanks for your past military service, but also thank you for what you do now. I know that’s a tough thing you do.”

I was honestly shocked silent by her words. I was humbled, but I was also reminded that nursing is something very special indeed. 

Yes, it is difficult, and you betcha it’s frustrating, but it’s also a wonderful thing to be a part of. Words can’t express the satisfaction the field can bring to your spirit, or the fulfillment you have after being a part of something miraculous. 

A newborn baby’s healthy cry, a tearful thank you from a grieving mother, or a strong, hearty handshake from a man you were certain wouldn’t pull through no matter how hard you all tried. 

The camaraderie felt amongst a fluid team, that self-satisfaction when you achieve something you felt was unobtainable (even just a crazy-hard IV stick). Or the joy on someone’s face when they finally go home!

A stranger thanking you for your service in the field of nursing. That pride only a nurse can feel. 

Maybe that was something I did want my daughter to experience, and at that thought I finally relaxed. 

Now I knew how my own mother (a nurse) felt when I told her I wanted to go into the field. Now that distant look in her eyes at the time made perfect sense. 

“You can be anything you want to be, baby. Anything at all.”

How to Keep Your Nursing Job From Killing You

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I recently was working with a fella who I think is a terrific nurse. He’s intelligent, well-skilled, and compassionate to boot. He basically holds all the characteristics of a great RN, but I noticed on our last shift together that he seemed quiet and withdrawn. Definitely not his jovial self. Upon some probing by me, he admitted his fatigue. 

“I think I need a break. I’ve been working so much lately; I just feel burned out.”

 

Photo used with permission from cheapnursedegrees.com


I love my chosen vocation of nursing, and most other nurses are in agreement with me I’m certain. But while it’s a well-payed job with great growth potential, I happen to believe that unless you hold a calling and driven determination to be a nurse, you won’t last long. 

So why’s that?

Well, nursing is extremely rewarding, but it’s also extremely taxing. As healthcare advances come along we are seeing our sick population grow older. Basically, we’re really good at medicine, and the benefit of that is longer life spans for our patients. This is wonderful news overall, but has the negative effect of nursing shortages. There are more patients than nurses, by a long shot, and this leads to many problems. 

Nurses are working more hours and taking care of more people. The nurse-to-patient ratio is unfairly skewed, and there’s only so much an employer can do to fix this problem. As a result nurses are more exhausted, additionally stressed, and we’re seeing increased medical errors being made due to less than desirable work conditions.  

 

Graphic credit: cheapnursedegrees.com

 
The physical toll of the job is taking its toll on nursing. Aside from fatigue and exhaustion related to long hours, multiple shifts, and overtime, we’re also seeing physical ailments aplenty. Most nurses I know have back problems, feet problems, or knee problems, if not all of the above. 

The act of constantly pushing and pulling another person’s weight is hard on a nurse’s body. Long periods standing and walking are stressing to muscles and joints. The risk for workplace infection from communicable disease can be life-threatening, and the violence found on the job related to confused or aggressive patients is a real threat to well-being. Even if you forget about the risks I’ve just mentioned, you still have the very real incidence of illness caused by the depleted immune systems of many nurses related to their stress and fatigue. 

But aside from the physical strains of the profession you must also consider the emotional ones. These are what I see often. 

 

Graphic credit: cheapnursedegrees.com

 
I’ve joked before that most nurses are on a nerve pill, but all laughs aside, emotional illness in nursing is a real thing. The stress of dealing with life and death is huge, and depression is a common diagnosis amongst nurses. It’s easy to spend so much time taking care of others that you neglect your own health, and mental wellness is an easy one to overlook. 

Like my friend I spoke of above, it’s easy for nurses to push themselves to the point of breaking, and it’s often not even until you begin to crack that it’s noticed. A lot of good nurses end up feeling very bad, and if the physical toll isn’t enough to take them out, it will be the emotional one that does the trick. You end up with something that you love killing you. 

There is no greater feeling than saving a life or receiving a tearful hug from a grateful family member. As a nurse I thrive on feeling like I’m doing a good job and making a difference, but in the end I am only human. We all are. 

As nurses we can save our sanity and health by taking care of ourselves, not just our patients. 

Take a vacation, even if just to sit around the house. Get plenty of rest; your body needs fuel. Don’t rely on alcohol or other unhealthy habits to ease your mood, but instead find great friends, peers, and mentors to bounce your feelings against. 

Finding an outlet, a source of strength from which you may draw support is very beneficial. I personally rely on my Christian faith to help me through more difficult aspects of my job. But in the end you may find a new environment is most helpful. There are all kinds of nursing jobs out there, and finding your comfort zone is best for the longevity of your career. 

It’s also important to remember a very simple word we all easily forget. “No.” Being a team player is super important, but if saying yes all the time is hurting you, then it’s time to say no. 

Being a Registered Nurse is one of the most rewarding titles I have ever held, but the other roles I hold for my family are extremely important as well. It’s tough to juggle the roles of quality family life and that of a proficient nurse, but it just takes some thoughtful prioritization. 

Above all, the important thing to remember is that we’re no help to anyone if we aren’t healthy ourselves. So you have to remind yourself as a nurse to nurse yourself first. It will not only save your sanity and job satisfaction, but it may also save your life in the long run. 

*You may find original graphic and other articles at this link.

25 Sounds That Stop a Nurse Dead in Their Tracks

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The other day I was having a rare, relaxing shift. It was that (I hate to use the word) “quiet” timeframe after you’ve discharged a patient, given morning meds, completed your initial assessments and charting, and you’re able to simply enjoy the calm that usually proceeds the storm. 

That’s the thing. You’re never completely subdued as a nurse. You’re always on-ready in case something crazy goes down, so even when you’re sitting back, maybe considering propping your feet up, you still remain alert. 

It was in one of these moments that my trusty respiratory therapist decided to use my empty room to test her equipment. I watched her walk in the room, and I knew what she was doing. Yet when that ventilator alarmed I sat up quickly, and my ears tuned in like a German Shepard. I was like Pavlov’s dog. I was conditioned over time, and that sound got my attention quickly. I almost salivated in preparation to fix something. 

I realized there are a lot of sounds like that. They get a nurse’s attention immediately. They turn a nurse’s head quickly, and they stop them dead in their tracks. Whether you’re at work, off the clock, in the grocery store, or even if it’s just a test, these sounds will get your attention if you’re a nurse. 

1. Ventilator alarm. 

Even when it’s not my patient this one always gets me. I can’t just sit there when one is going off. 

2. Screeching tires. 

Was that a wreck? I wonder if someone is hurt? They probably need a nurse. 

3. Monitor alarm. 

Nine times out of ten that V-tach alarm is not V-tach. It’s artifact. But you gotta look, right?

4. A child crying. 

This is a mom thing too. As both, when I hear a child cry I feel compelled to help them. 

5. IV pump. 

Curses. I hear you in my sleep. And you’re coming from every direction. Could be someone bending their elbow for that KVO saline, but it could be much needed Levophed. Grrrr. Better go check. 

6. The sound of an O2 tank falling over. 

If you’ve ever seen one of these shoot across the room then you’ll not only look up at the sound of the crash, but you’ll also take cover. 

7. Someone crying “help!”

Is that a citizen in need that I hear? Where’s my cape. I. Am. Batman. I will help you. 

8. An ambulance siren. 

Where, where?! Could be an MI. Could be a trauma. Could be the common cold. A nurse goes through twelve different scenarios before the siren fades. 

9. Code button. 

Ahhhh. It’s on! Run. Grab the crashcart. Please don’t let that be mine!

10. Door buzzer. 

I don’t wanna hear this one, but I do. Over and over, and over. Sorry, no one under twelve. 

11. The sound of a rolling crash cart. 

Sometimes we go ahead and grab that cart in anticipation of doom, don’t we? It’s a distinctive sound that gets your attention for sure. 

12. Call light. 

Yes, I hear you in my sleep also. Coming. 

13. A scream. 

What’s that?! Run! 

Oh, you need your blanket. That’s not the boy that cried wolf at all. Sigh. 

14. The sound of the bathroom pull string. 

No! Don’t stand up on your own. You have zero venous access left if you pull out that right AC. 

15. A police siren. 

I’m not in the mood for a gunshot wound. Man, I hope it’s not a gunshot wound. 

16. The sound of something, or God forbid, someone hitting the floor. 

Please don’t be a subdural bleed! No incident report, please. 

17. An overhead intercom. 

For real, I’m so conditioned that even if I’m in Walmart I tune in to the overhead announcement just to make sure they don’t need me somewhere. 

18. The sound of running feet. 

Ahhh. What’s going on?!

Subsequently, try not to run unless it’s an emergency. It saves the nurse a heart attack. 

19. The bed exit alarm. 

See #16 for details. 

20. A helicopter. 

Flying in? Or flying out? Is that room clean?!

21. The sound of a Bipap being removed. 

Oxygen is our friend. Let’s keep it at a level compatible with mentation, Mr. Smith. (Or we may end up referring to #16.)

22. Someone yelling, “hey!”

I don’t want to answer to “hey,” but I always look up anyway. 

Who, me? How may I help you, ma’am?

23. When someone says, “we’re getting a patient?”

Internal battle. Do I go hide in the bathroom and pretend I didn’t hear?

Is it really my turn?

24. The sound of a gurney rolling up the hall. 

Here they come. Ready or not. Get your game face on. 

25. (My favorite) Y’all wanna order out lunch today?

Uh, yeah. Duh. 

I’m certain I’ll hear most, if not all of these on my next shift. I hope I definitely hear #25. 

So, yeah, all these sounds will get my attention in a hurry, but I wouldn’t have it any other way. After all, I’m a nurse!

Now where’s my cape? I swear I just heard someone cry out “help” in the distance.  

A Letter for the New Docs From Your Nurse

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Dear Residents,

It’s that time again, the new season of change where we bedside warriors watch with pride as the doctors we’ve come to respect and love graduate their residency program. Like a proud parent we wipe a moist eye and wave farewell to the well-learned physicians we’ve fought tooth and nail with as they finally earn their wings to fly. Some will stay, and some will move on, but all will be remembered by the nurses who served alongside them. 

And then new doctors arrive in their place. New, first-year residents come on board to complete their long journey toward obtaining their career goal, and we struggle to learn new faces and match them with new names. We also strive to mesh with new personalities that are beginning to emerge confidently. 

First off, congrats. I’m happy for you, and I’m proud of the career path you’ve chosen. We need new doctors to pick up the reigns and drive this horse of healthcare. But as a seasoned bedside caregiver I wanted to remind you of a few things to help make our partnership a pleasant and effective one. 

So here goes. 

I am fully aware of your educational level, and yes, I’m impressed. You have attended school at a higher level of learning than myself, and much longer. Your knowledge is extensive, and I respect that. You’re a doctor, and I respect that too. I do. You have chosen a path different than my own, and I admire your determination. 

But I only ask for some mutual respect and acknowledgement of my experience, education, and personal sacrifices. While you do hold a positional title above mine it so happens that I’ve been doing this patient care thing much longer than you have. In that time I have observed a lot. I see what response occurs in relation to specific interventions, and I’ve even seen the oddball reactions that hardly ever happen. I have book knowledge too, but I also have bedside experience that can only be gained with time. In other words, been there, done that. So perhaps my suggestion is worth entertaining without disdain. 

Here’s another one. I’m here all the time. I’m here with the patient from the moment they arrive, and I hold their hand as they cry in pain and frustration. I possess a lot of useful information in my brain about that person lying in that bed, and it’s stuff you can’t get from their medical record. 

I hear the stories, I hear the complaints, the symptoms, and the stuff they forget to report to the ER physician. And the other thing is that when you arrive you’re like the third doctor to come by in a thirty minute period. They’re kind of tired of repeating “what brought them here,” and they leave out a lot for sake of brevity and their own sanity. I can help fill in the missing pieces if you’ll give me the chance. 

Of note, what you see on the monitor when you breeze through the unit might not be the whole story. Patient presentation is a big picture, but it’s easy to forget that when faced with a full patient load. I get it; just ask me, and I’ll be glad to share my knowledge of the patient’s entire clinical presentation. That’s kind of a big deal, you know?

As a nurse, being at the bedside the duration of the patient’s stay, I am privy to information that is highly valuable to our team approach. I know how they’re reacting to the orders you’re putting in, and I understand how they might react based on my prior, extensive experience. I don’t mind if you put a little trust in me. I won’t tell. 

Above all, we’re a team, you and I. I need you, and I hope you’ll see that you need me too. We have a plethora of sick folks who are counting on us to to make a difference in their future health so we better get to it. 

Those who have gone before you have proven themselves well, and together we’ve rocked it out. We’ve caught problems before they became travesties, saved lives, and discovered the qualities we each hold in this great, liquid machine that is patient care delivery. 

So here’s to keeping a good thing going! Just remember what your nurse can bring to the table, and we’ll do fine. 

Good Luck,

Your Partner in Care, Your Nurse

P.S. Remember, your nurse is always right. 

P.S.S. Sorry about waking you up. Again. 

5 Biblical Truths to Encourage Nurses

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I’m the kind of woman who draws her strength from the Lord, but after an especially difficult shift as a registered nurse I will sometimes find myself feeling weak. I may even feel defeated, as if I am an absolute failure at what I’m trying to do. Or I may feel like I just don’t have what it takes to give my patients what they deserve. 

It’s in these moments of occasional, but understandable discouragement over a very difficult vocation that I must remind myself of the solid truths about myself and my profession that can be found in God’s word. 

Here are 5 Biblical truths I try and remember, and that I repeat to myself in those moments when I need encouragement the most. 

 
1. Remember where your strength comes from. 

Philipians 4:13

I can do all this through him who gives me strength. 

Y’all, nursing is hard, and that’s why this is my power verse. I will never know all the answers, catch every problem before it becomes a big issue, or get every single thing right. It’s just too complex of a position to expect perfection of one’s self. But I can rely on the one who is perfect. I can pray to hear His voice as I go about my day, and I can agree to trust the Lord to supply me with the resolve I need to do my job well. 

When I cannot, he can. I can do all things through Christ who gives me strength. 

2. Remember why you’re doing what you do. 

Colossians 3:23

Whatever you do, work at it with all your heart, as working for the Lord, not for human masters,

As a Christian I believe that every move I make and every action I perform is a direct representation of who I am in Christ. Every task I perform is for his honor and his glory. So in essence everything I do should be done unto him, in his honor, and for the furthering of his kingdom. 

What I do matters. Whether it’s wiping someone’s bottom, holding a frightened woman’s hand, titrating dangerous cardiac medications, or even charting, I am doing it for the Lord. I am serving his people, and I would like to think that makes him proud. 

In this regard it only makes sense that I try and do what I do with a joyful heart. This isn’t always easy, and I fall short often, but that’s why it’s a good reminder. It’s a great thing to keep in mind that my actions are working according to his purpose, that my attitude represents his kingdom, and that God can use even little ole me to accomplish wonderful things. Now that’s encouraging. 

3. Remember that fear isn’t necessary. 

Psalm 118:6

The LORD is with me; I will not be afraid. What can mere mortals do to me?

It’s really easy to become fearful in the frightening world of healthcare. There’s so many unknowns, so many things that can go wrong. I find it extremely helpful, though, when I remind myself that there is no unknown to God. 

He knows what assignment I will receive, how my patient will react to intervention, and what the eventual outcome will be. He holds it all in the palm of his hand, and as I trust in him, he will guide me. 

In nursing fear will come, but it’s not necessary to hold onto that fear when you remember your trust lies in the creator of the universe. When you rest in the shadow of the almighty he will give you peace, not fear. Fear is from the other guy. 

4. Remember that God has you where he wants you for a reason. 

Proverbs 3:5-6

Trust in the LORD with all your heart and lean not on your own understanding; in all your ways submit to him, and he will make your paths straight.

Romans 8:28

And we know that in all things God works for the good of those who love him, who have been called according to his purpose.

It’s easy to get frustrated at times with where we are in our career. You can begin to question if you’re in the right setting or field all together. It’s easy to become discouraged, and in those instances it’s imperative to hold tightly to the calling God placed in your heart in the beginning. 

Sometimes we are where we are for a season, or we must transverse a difficult, dry patch to get to the other side. But whatever the situation you can always trust that God has control of your destiny. He will open doors, and he will close others. 

He will guide us to new places if and when it is his will, but he will always provide us with what we need for where we are. And his purposes are always fulfilled where he has placed us. Even when we cannot see. You just have to trust that he is working it all towards your good, in his perfect knowledge and time. 

5. Remember who’s in control. 

This is a hard one for nurses. Nursing is a field where your actions and decisions are a huge deal, and in reality they can mean life or death for someone. In that line of thinking it’s easy to become stressed out as you feel you must manage and control everything. But when it comes down to it you don’t have control. You just don’t. 

While this is a hard thing to admit, I find it’s actually easier when I can remember that the outcome of my patient isn’t really in my hands. I can do the best I can do, but in the end I have to surrender my performance into the Lord’s hands. And when I do that I can actually catch my breath. He’s in control; he’s got this! Thank God.

Isaiah 55:8-9

“My thoughts are nothing like your thoughts,” says the LORD . “And my ways are far beyond anything you could imagine. For just as the heavens are higher than the earth, so my ways are higher than your ways and my thoughts higher than your thoughts.”

Isaiah 41:10

So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand.


What’s It Like to Be a Nurse?

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What’s it like to be a nurse?

It’s a fair question, and one I’ve been asked a time or two. Sometimes people think they know. After all, you’ve seen nurses congregated at the nursing station, laughing, talking on the phone, feet propped up on a chair. Must be a pretty relaxed job, huh?

Or some folks think about the cheddar. They figure with the big bucks nurses bring home from typing on the computer and checking temperatures it must be the best gig around.

Or perhaps they watch a lot of TV, fun shows like Scrubs and Grey’s Anatomy. Maybe they think it’s a bunch of pranks on the new guy and flirting with cute doctors.

Maybe. 

But maybe it’s like this. 

Maybe as a nurse when you get a new patient you realize that you have no clue. I mean, you get report and stuff. You look at labs and X-rays. You know from clinical experience and years of knowledge sort of what to assume will come through the door, but you also understand that you can never really know. 

Sometimes your patient may be stable, and that’s really great. But more often than not they aren’t. More often than not they’re confused, and even as you beg, “please don’t pull that tube out of your nose,” they do. 

Maybe being a nurse means you live in this uncertain environment, and even though you’re taught how to respond when stuff goes down, when it happens, your heart still races. 

Perhaps being a nurse means expecting the unexpected, because that’s nursing, but still feeling helpless when your patient goes into respiratory distress while you’re both in the elevator. And as you rush down the hall, pulling a heavy bed with your five month pregnant self, you pray, “please, just make it to the room!” 

It seems like being a nurse means thinking quickly while you watch numbers on the monitor screen plummet to ones incompatible with life, and even as you silently wish them to go back up, they do not. 

Maybe nursing is fighting, and then fighting some more. I guess it’s being in a packed room with a group of your professional peers while quick, curt instructions are pounded out. It’s trying to intervene, to do your part, to remember everything you know, and to keep your hands from shaking despite your adrenaline pumping double-time. 

It seems that nursing may end up being a continuous adrenal rush to keep going, to keep fighting to save a life. It’s pounding on someone’s chest, making their body jump off the bed with electrical shocks, and administering dangerous medications, all while watching that darn screen and willing it to show you something good. 

Maybe sometimes nursing is sitting at a desk, but then other times it’s standing at the bedside, going on the third hour of continuous intervention to bring someone back from the brink of death. 

It’s reaching your limit emotionally, physically, and mentally, but being unable to stop because the situation at hand won’t allow it. It’s digging deeper into self than you knew possible, forgoing a bathroom or water break. Heck, forgetting you’re even human enough to require such things. It’s reaching that end of your rope, and then magically finding more rope. 

Then perhaps nursing is breaking bad news to family, and wishing, just wishing that you had the right words to say. It’s dreaming that you had a magic potion of comfort in your scrub pocket, but as you hold a crying wife on your thin shoulder, realizing you do not. You do not. 

Maybe nursing is giving it all you have, and barely being able to tread water at times. It’s fighting and fighting to keep someone alive until your relief arrives. 

And then it’s charting the past, chaotic thirteen hours. It’s trying to remember all the important details to document for quality improvement and your own legal protection, but feeling so frazzled and mentally drained that you are certain you’re missing something. 

Then perhaps nursing is going home way after your shift should have ended, dragging yourself to your personal car, and then reliving the past six hours on the drive home. It’s mentally berating yourself for not being fast enough, quick-thinking enough, or enough of a miracle worker to prevent the downfall of the person who trusted you to care for them in their hour of need. 

It’s knowing you did all you could do, but beating yourself up because you wish you could have done more. 

It’s wondering if your patient you fought so hard to keep alive through your shift will make it through the night. And then wondering if you’re up to battle again tomorrow if they do.

It’s knowing you can, and you will, because that’s what it’s like to be a nurse. It’s giving all you have, and then going back to give some more. 

Nursing; it’s sore feet, a headache, and an aching back. It’s worrying about someone you don’t even know, and praying comfort for family whose names you have forgotten. It’s going to bed, despite your mental anguish, so you may be rested enough to fight another day. Because that’s what it’s like to be a nurse.