What's The Count Now?Some new nurseblogger friends have been linked up today! Go check them out and share the love. :)
The Kniting Wannabe
Time to Lean
Rich Girl, Poor Girl
When I Was in College
From the Carolinaâ€™s to Georgia
Sister in White
The Road to Braj is Strewn With Thorns
Night Shift Sleep Cycle QuizNight Shift Sleep Cycle Quiz
by Vicki Cadwell RN, BS, CEN, MICN
Capistrano Beach, California
As published in the Journal of Emergency Nursing 1998;24:377
1) If Helene, who works the night shift, goes to sleep at 9 am and receives a phone call at 1 pm, what is the equivalent time on the sleep cycle of Joan, who works during the day?
A. The middle of the afternoon.
B. The middle of the night
C. It is 1 pm no matter what shift you work.
D. It does not matter because people who work the night shift do not need to sleep anyway.
2) Helene, who works the night shift, has had how much sleep when she is awakened at 12 noon?
A. Enough -- anyone can sleep until noon.
B. Who can sleep during the day?
C. Only about 3 hours.
D. Plenty -- people who work the night shift sleep faster than people who work the day shift.
3) If Joan, who works the day shift, received a phone call at 2 am asking what was charted on Mrs. Smith 2 days ago, how happy would she be?
A. Ecstatic -- Mrs. Smith must have sent candy.
B. Unperturbed -- people have immediate recall in the middle of sleep.
C. Very happy -- phone calls are welcome any time of day.
D. After only 4 hours of sleep, how happy would you be?
4) How convenient would it be for Joan, who works the day shift, to attend a meeting scheduled for 10 pm?
A. It would be very convenient for Joan to wait for 2 1/2 hours after her shift ends.
B. It is no big deal for Joan to work 12 hours and then stay until 11pm or so.
C. It would be like scheduling a 10 am meeting for a person who works the night shift.
D. Convenience is not a factor -- meetings are important and should be attended no matter when they are scheduled.
5) The best time to call Helene, who works the night shift, and ask her to work an extra shift is:
A. 9 am -- that is the best time of day for the charge nurse to make phone calls.
B. Noon -- The night shift person is probably eating lunch.
C. 2:55 pm -- right before "oprah." All people who work the night shift watch daytime talk shows.
D. After she has had at least 5 hours sleep, because that is when you are less likely to get a rude response.
Still More LinksI went to work my shift in the CCU today, not much happened. We had a very low census of not-quite-so-sick people. Four of them got transferred out by the end of the shift, and only one more had come in by then. I had a CNA student following me today. I think students are pretty fun, and it sort of surprises me to have one (my own RN clinical experiences fresh in my memory). The nurses share my excitement that graduation is so soon.
After I came home and showered up, I took a nap and then my hubby took me and the kiddo to Denny's for dinner. I thought about kicking my feet up for a while when I got home, but I couldn't find anything that I wanted to watch on the tube, so I put up a few more links. Some of these blogs make you sign in to leave a comment, so I didn't let them know I'm linking up to them. Why do some of the blog services do that? Is it so important for them to collect information from every single person that comments? I've heard a few people post bad things about blogger, but I've had absolutely no problem with it at this point (probably just jinxed myself...)
New Additions to NurseBlogs:
Diary of a Nursing Student 2
Nurse Ratchettâ€™s Alter Ego
Tales of an Aspiring Nightingale
Scott Chisholm Lamont, RN
Enjoy your weekend - I've got work tomorrow, but the whole family has Monday off!
Nurses From AbroadI was reading something the other day about the influx of nurses trained in other parts of the world, particularly Africa, where in some countries education of doctors and nurses is completely funded by the government. Some African countries are paying to create nurses and doctors, only to have them leave and take their skills to the US or UK.
African hospitals are overflowing with patients, yet they cannot hope to offer medical staff the pay that can be made by coming here. I found another story about the situation in the UK:
"[the] report focused on Ghana, where the flow of nurses to the UK has soared tenfold in the past six years and the number of doctors has doubled. The Korle Bu teaching hospital in Accra is 1,000 short of the 2,000 nurses it needs, and 60 per cent of the babies in its intensive care unit suffered asphyxia at birth because their mothers were not properly monitored during labour, owing to the shortage of staff.
The director of the hospital, Professor Kawabena Frimpong-Boateng, described the staff shortage as "devastating" and appealed to the UK and the US to show restraint, by restricting their recruitment to medical staff who had already served at least five years in Ghana. "We don't think we should be paying for the training of doctors and nurses to work in the UK," he said.
The findings were backed by a study in The Lancet that said half of the 16,000 extra staff hired by the NHS in recent years had come from overseas, with damaging effects on health services in sub-Saharan Africa.
Steve Webb, the Liberal Democrat health spokesman, said: "It is appalling that, as one of the richest nations in the world, we are draining developing countries of their doctors and nurses. Overseas staff have a valued place in the NHS but must not be exploited to cover up the failure to recruit and retain home-grown doctors and nurses."
Why does it seem easier to import nurses than to support the training of them here? The nursing shortage is fueled by the fact that there are not enough spots for students to get into nursing programs. There are not enough instructors or programs.
Just as you sacrifice quality by getting the frozen pie rather than making it yourself, going the easy route and letting doctors and nurses immigrate (and even actively recruiting them) to the US rather than supporting programs here is going to hurt US healthcare and completely devastate the healthcare systems in developing nations.
CDC Reports On ED UseA record 114 million Americans visited a hospital emergency room in 2003, despite a steady decline in the number of E.R. facilities available nationwide, the U.S. Centers for Disease Control and Prevention said in a report issued Thursday.
While E.R. visits shot up 26 percent over the decade from 1993 to 2003, the number of emergency department facilities fell 14 percent over that span.
People over age 65 accounted for the bulk of the increased visits to emergency rooms. Medicaid patients were four times more likely to seek treatment there than people who had private insurance, indicating that the E.R. was often the place of first resort for poor and uninsured people.
The most common reasons for visiting the emergency room were injury, poisoning, and the adverse effects of prior medical treatment.
-news release from the CDC-
You Know It's Gonna Be BadWhile hunting around for more nurseblogs, I came across a website made by a nurse that she closed (you get a message that says "It's been fun, but this website is now closed"). She had some funny things on there that I copied to put here so they weren't lost. Some of these have authors, some don't, and where I saw one mentioned I will give credit. I know I've seen a few of these lists before but many of you may have not, so here is the first one. Feel free to add to the list using the comments. - HK
You Know it's going to be a bad day in the ER when:
You show up for work and notice bars have just been installed on all the windows and there is now a metal detector at the hospital entrance.
The paramedics in the parking lot are all using mops to clean up their ambulances and the EMTs are using a hose.
The off-going shift has a hard time keeping a straight face when giving report, especially about Room 15.
Your first patient of the day insists there is no way that she can be pregnant. She's crowning.
Your next five patients and their families all scream at you in different languages, none of which you speak.
Your next patient screams at you in a language you do understand, but you can't remember hearing that many obscenities strung together at once.
The intoxicated 250 Kg. transvestite in Room 15 keeps trying to get your home phone number because you "are just too sweet."
Your next patient has maggots but isn't dead.
The hospital's attorney wants to talk to you but her secretary won't tell you what it's about.
The hospital has a surprise disaster drill. You were the only one who wasn't tipped off.
The Department is completely empty and one of the off-going shift says, "It's been that way all night, hope you have a quiet day!"
No one remembered to buy coffee.
You have writers' cramp and still have 7 hours of the shift left.
The psychiatric patient who thinks he is Jesus was placed in the same room as another patient who thinks he is Satan.
You get a subpoena for a lawsuit a on a patient that walked out of the department against medical advice two years ago. You can only hope that is what the attorney wants to talk about.
The Hospital Administrator left you a cryptic message about a news crew showing up "sometime today to do a little filming, so everyone act natural."
In the middle of a disaster drill two real trauma patients present themselves.
The paramedics who offered to go out and pick up lunch (and coffee) just advised over the radio they have witnessed a motor vehicle accident involving a transit bus versus a minivan. "Stand by for update."
It's the first day for the new medical interns, paramedic and nursing students all at the same time.
The paramedics tell you the patient you just received with a closed head injury, flail chest, and positive belly tap is in "much better shape than the one still being cut out of the minivan."
You hear there is an influenza epidemic traveling like wild fire through the local convalescent homes.
The psychiatric patient's delusions are beginning to make sense.
Â© 1999 by Jerry Fandel.
Added by HypnoKitten:
Your charge nurse asks if you know how to use Qwell.
Your next patient's wife introduces herself as one of the Board of Directors of the Hospital.
A cancer patient who wanted to die at home became unresponsive and agonal breathing, so the family called 911 and decided to make him a full code.
The police bring you a drunk because they don't know what else to do with him.
In the waiting room, the lady who's daughter may have broken her wrist is screaming at you because you let the sweaty man with chest pain and history of MI go back before her.
The charge nurse asks if you have any trouble swallowing really big pills.
New Nurseblogs AddedI'm busy studying this evening, but I took some time to add a few new nurseblogs to the links for you to look at.
Abortion Clinic Days
Bruceâ€™s Day to Day Life
Ringings From a Southern Belle
RN of Mental Health
Becoming a Nurse
I don't know if Abortion Clinic Days is written by nurses or not (it's a team blog) but it seems like it is. I may be able to find out more later.
Hypnosis Helps Kids Cope With NeedlesSome of you may have read that I have a great deal of interest in using hypnosis to help patients relax and ease pain. I found this article today:
"Adelaide doctor Graham Wicks is one of a few Australian pioneers using hypnosis to treat children with problems ranging from headaches to nightmares.
For children who suffer from kidney disease, the painful prospect of blood tests and daily dialysis can be a scary ordeal.
"Sitting for three to four hours, at least three times a week, and having a large-bore needle thrust into an artery - and I've seen patients who've had dialysis for maybe a year or so, aged 12 or 13, who've suddenly said, 'I don't want to have that any more, I cant tolerate it'," he said.
"And even though these children are told, 'If you don't have it, you're running a grave risk of not surviving', I've had patients who've still said, 'Well that'd be better than what's going on now'.
"They're the ones you can really help [with hypnosis]," he said."
The Power of GoodbyeSeattle Times, May 19th, 2005
One cancer patient calls them "MIA doctors" â€” doctors who go missing in action when their patients are about to die.
Doctors, even with patients they've known for years, often avoid saying goodbye, says Dr. Anthony Back, a cancer specialist who teaches young doctors communication skills. And their inability to say those little words often leaves patients feeling perplexed and abandoned at an especially vulnerable time.
Back, who wrote about the problem in last month's issue of the Annals of Internal Medicine, said he was stunned when he asked his students, all cancer specialists in their last stages of training, if they acknowledge to patients about to die that they won't be seeing them again.
-the rest of the story-
Too Nice 2B InsideI was just waking up this morning and thinking about the 'nurseblogs' logo tag and wondering if people were cutting and pasting it to their own blogs when I realized that I had right click disabled on my blog! SO, If you tried unsuccessfully to cut and paste the code for the little tag, please try again. You can now right-click.
I also added about 4-5 more blogs, the list keeps growing. One of the links is for a blogging nurse in Portugal. It's not in English, unfortunately. Maybe if she knows we're interested she'll post a bit in English. (It doesn't seem to be working at the moment, but I'll fix it by tomorrow night - HK)
For any students - if you want a countdown timer like I've got over on the left, you can get the code here. It would also work for vacations, weddings, or whatever. I made the flashing title myself.
I got another scholarship this year from the 40&8 (they gave me one last year too!). This veterans group's scholarship program is dedicated to student nurses. The website doesn't have very much information about them, so you'll have to contact your local chapter. Really, honestly, I'm telling you do this if you need a little bit of extra help, because the only requirement to getting a scholarship is that you be enrolled in some sort of nursing program. Not a lot of people know about this. They gave me $550 each year. Larger chapters (voitures) would probably give more.
Did anyone else get this in their email? I guess California nurses are talking about striking. Interesting. I wonder what will happen?
Something FunI'm just playing now. What a goof.
I made this little thing, I hope you like it. If you want to show the world you're proud to be part of the new NurseBlog community (without filling out silly forms, and giving up your personal information) then you can put up this button I made tonight (rather than doing homework).
Just cut and paste this bit of code into your template:
<a href="http://mediblogopathy.blogspot.com"><img src="http://www.geocities.com/neverlost_seattle/NurseBlogsTiny.gif"></a>
If you don't like it, and you don't want to use it, don't worry about it - you'll still have a link here.
I wanted to let anyone reading know that I also will be adding a few links to blogs written by nurses that don't talk about work much at all. They're just our friends, co-workers, fellow nurses who like to show what they do for fun and talk about their families (both human and non-human). Don't think you've always got to be on-topic about nursing - heck, I don't even do that! Let me know if you agree. Maybe at some point I'll divide up the blogs into categories of work and personal, but right now there are only a couple that never talk shop. Besides, it took me a while to get these in order....
Spanish For Health Care ProfessionalsI was reding this post from May over at About A Nurse, and I couldn't help but tell her about the book Spanish for Health Care Professionals .
I managed to find my copy at Half Price Books (a used book store chain, you might have one in your area) but I would have to say it is definately worth full price. It reads sort of like a friendly spanish lesson, but teaches you how to say what you want in 'common language' spanish (the words and the pronunciations), rather than trying to make things too difficult. It's also got everything I can imagine to do any sort of medical assessment and history collection, broken down by chapters arranged in each category (i.e. peds, MVA, chest pain, elder care, even how to use the call light and the menu). It's not a huge book, but I can't think of anything I would want to say that isn't covered in it.
Vamos a sacar un poco de sangre de su vena = We're going to draw a little blood from your vein.
Se queda sin aliento despues de hacer un esfuerzo? = Do you get short of breath upon exertion?
Alrighty Then51 (yes, fifty-one!) links to other nursing blogs, took me a while to get it done but there it is. If you know of a nursing blog that isn't in here, let me know. More will be added as I find them.
I've got to get some sleep, I've been so busy the past few nights I'm getting about 4 hours of sleep, and this makes me sort of dumb. I've got my first of what will probably be many job interviews tomorrow, so hopefully I'll do well. I bought a new pair of slacks and dress shirt last night because I know if I don't have to worry about how I look I'll be able to concentrate better, plus I can wear it to many more interviews.
I have a few stories I want to post, but they'll have to wait until tomorrow evening.
When Rules Get In The Way of RightIt seems there's a death-row inmate in Fort Wayne who is slated to die by lethal injection on May 25th, but he's making appeals right now to postpone the execution. His sister is a diabetic newly diagnosed with steatohepatitis and needs a liver transplant soon. The inmate, covicted of killing an elderly woman and setting her house on fire, wants to give his liver to his sister. Easy enough, right?
It gets messy though, because the lethal injection may poison the organs and make them unusable. Electrocution is not legal in the state, but he says he'd do it if his sister could then get his liver. There is an option to give her half of his liver, and then let him heal up until he's well enough to be executed. Of course, it would be better for his sister to get the whole thing, but he would die if it was removed, and that's not legal either. And who would operate on a perfectly healthy person and remove his entire liver anyway? I'm no ethicist, but I'm betting physicians wouldn't be lining up for that one. (Ok, well some might...)
I don't know any good reason why they shouldn't change a rule or two to allow prisoners to donate their organs, there's got to be some way to do it - especially if the prisoner agrees.
Of course, someone else probably has an equally good reason why we should not let him do it. I'd like to hear it, though.
Here's one of the stories about it.
Last Peds ClinicalYep, today was our last peds clinical day. I took it easy today, and spent a lot of time playing with the (jaundiced) baby I was assigned to. There wasn't much going on on the unit, and I was assigned to an RN/LPN team that only had 4 kiddos, so things were breezy. I like charting and feeling like I actually should be doing it rather than that feeling I used to have that I was an interloper. Other students stopped in to see my patient - he was cute, but that scary yellow color...
I spent some time today updating my links. I am going to make another graphic to divide the links between nursing links and docs or other medical people. I know I have a bunch of nursing links already, but there are about 20 more that I need to put up. I've found tons of other bloggers out there - this is really neat! If I've linked to you, make sure to link back to me so that we're all connected. Once I get the blogring going, it will be even easier. :)
(Stolen from YorKoi.com)
StuckWe had an interesting 'assignment' at school as part of out mother/baby section. We were sent to a house where medically fragile children live when they can't live at home. We had to spend 8 hours there, and needless to say, since I have really no interest in working in peds I wasn't thrilled at the prospect.
I happened to get there after a student from a local LPN course, and she was already over in the corner reading a story to a 5 year old boy. The nurse in charge told me that they were sort of 'short on kids' that day - there were only two babies besides the 5 year old. I thought to myself "Dang, I gotta hang out with a baby all day. Too bad the other student took the kid, maybe I could have at least had fun with him." (of course you know I smiled on the outside, and happily sat down to watch Veggie Tales...)
As the day progressed, I started to have a bit of a bond with my smallish kiddo. She wasn't fussy, and didn't cry much at all. She did smile - a LOT. She was actually a very happy baby, and I was relieved. Pretty blue eyes. Big gummy smile. Not a new baby - she was about 9 months old.
Now you may think this is new to me, but I do have my own child. I'm not prone to getting all mushy and worked up over every baby I see. This particular baby was just so nice. Her story ties your heart in knots (her parents couldn't/wouldn't take care of her and basically gave her to the state). The nurse had said at the beginning of the day that I would not be able to hold her beacuse of all the wires and tubes she was hooked up to, but after she was bathed and dried, I asked. We sat down in the rocker next to the bed - very close so all the wires would reach. She made little baby noises and smiled big when I sat her on my knee and bounced her softly. She actually smiled so big the nurse went to get a camera! (yeah, I'm getting mushy)
Anyway, that was that, and I left at the end of the day thinking about how sad it was that she was a ward of the state and really didn't have a family other than the nurses anymore (I guess she didn't have much of one before, but thats all heresay). Obviously she was really happy to get the extra attention, and someone to take care of just her.
Well, the gets strange a week later. Of all the days I could spend in clinicals at all of the hospitals I could have been assigned to - and of all the floors and of all the nurses I could have been assigned to, I managed to get in the same place as my little baby from the home! I went in to visit her when her nurse was changing a diaper. I said "Hi, baby - remember me?" and she looked right at me and smiled that same huge smile and tears just welled right up in my eyes. Yeah, she could have just been reacting to having someone talk to her, but right at that moment I could have sworn she did know me.
So the nurse and I talk about her case, how sad it is that she hasn't got a family now and how she needs to find a foster home. Later, I tell the other nursing students on the floor to come and see "my baby" from the previous assignment. I wish I could do something for her - I wish I could be her family. (God, woman, get a grip on yourself.. you know this can't work...)
I'm home and telling my husband about my day - the same baby from the week before, funny coincidence. Ha-ha. Boy, it sure is sad about her condition. It sure is so sad she doesn't have a family and needs a foster family (and I am, of course, qualifying it with "but I know we can't do anything about it..." because I know he's just going to say "no" and think I'm crazy to suggest it.)
After telling him the story (little tears in my eyes) he only says "Does the state give money to pay for her medical care, or do the foster parents have to pay it?". I looked at him, this caring man who took on my daughter as his own, and told him "Yeah, they do. But I know we can't do anything about it." He said "I know. We can't do anything about it."
Theres so much going on right now. I'm in school and working, and he works full time. I'm wondering whats going on - why am I getting all caught up in this when I know there's just no time and no space and no way right now. Especially for a baby so medically fragile that she'll need 24-hour care. Especially for our little family that has struggled to make ends meet for the past four years while I went back to school. We've been waiting for me to go to work full-time so we can pay down some of the credit cards and save up for a down payment for our own house. We need to move out of this crummy area of town and get someplace where my daughter shouldn't be afraid to walk home from school. What's more, baby's prognosis isn't good, and her life expectancy is not long from what I can tell. So I'm stuck.
There's a message here, but what it is I really don't know. I've got some ideas, but no epiphany. What are the chances of her being in the same hospital at the same time (even the same corner of the same floor) as me? Why this baby, when so many others don't affect me at all?
The whole thing still makes me incredibly sad.
35 Days 'Til PinningIs any post really necessary? Can't you feel my joy coming right through the computer screen?
Flying Solo, Nurse is EnoughSeattle Times
Flying solo, nurse is enough
Tuesday, May 03, 2005
Joanne Endres had gotten used to the bouts of burnout and the weary
knowledge that people don't get what she does for a living.
Then she kept a man from dying. And all that changed.
Endres, 50, an emergency-room nurse at Evergreen Hospital Medical
Center in Kirkland, was on a plane from Minneapolis last month when an
attendant asked that anyone with medical training come up front.
Endres, the only one to come forward, found a 54-year-old man showing
all the signs of a heart attack.
He managed to tell Endres that he'd had bypass surgery, had a pacemaker
and was carrying nitroglycerine. She had him take one, and an aspirin.
From there, time halted and skidded, like a child on ice skates. The
pilot turned the plane around. Endres did her best in the narrow, bumpy
aisle with the plane's medical kit as the man fell in and out of
Others helped: One woman, hands shaking, tore tape for Endres to attach
an IV. A man held the IV bag aloft.
As she monitored the man's improving pulse, Endres joked, "Some people
will do anything to hold my hand."
He smiled weakly, thanked her. A tear ran down his cheek.
The plane landed and the man was carried off. As Endres headed back to
her seat, everyone cheered.
For the first time in years, people asked, really asked, what it was
like to be a nurse.
"She just knew what to do," one passenger marveled. "And there wasn't
even a doctor there!"
Endres was grateful for that, and that someone "didn't have to call the
man's daughter and tell her, 'We are very, very sorry, but your father
died on the plane.' "
The two free gin and tonics were nice, too.
When Endres got home, she e-mailed family and friends about her
The e-mail has spread to nursing staffs, schools â€” and others who
needed reminding of what nurses do.
Dr. Charles A. Pilcher, an ER doctor at Evergreen, sent Endres' e-mail
to his staff, with this addendum:
"I guess the only way a nurse can get recognized for the truly quality
work you all do is to do it when there's no one else around to take the
credit," Pilcher wrote. "I bet Evergreen could run for several days
even if none of the doctors showed up."
On Saturday, the Evergreen Foundation will hold its annual "Heart of
Evergreen" Gala at the Meydenbauer Center in Bellevue. Proceeds will help
create a nursing institute at Evergreen. Five nurses will receive a
Nursing Excellence Award. Endres is a nominee.
The man who held the IV bag was a priest from New York on his way to
visit his friend â€” a nurse. A pilot wrote to tell her how "scary" it is
when there's no one to help.
As for the man she saved?
"We were met by the medics, and I don't know," she said. "But even if I
don't hear from him, this story was meant to do a lot more. If I am
helping nurses feel validated and inspired again, I am thrilled."
I've Been Working HardI haven't posted in a bit, but I think it will all be worth it in the end. I've been searching all over the internet for other nursing blogs and I've found quite a few. I've got about 50 other blogs, including some from across the globe. I'd like to make an RN-blogring, and then a larger MEDI-blogring, so if you're reading this and you'd like to participate, just let me know.
I think I may be ready to go in about another week, just a bit more planning. Once I make this thing, I don't want it to die off after a while because the service I go with goes out of business or whatever. I want to make sure it's really solid.
I'll keep you all updated.
ALSO, if you know how to set up an RSS feed, would you let me know? You can email me at neverlost_seattle (AT) yahoo.com.