For the brave medical professionals who worked Halloween...

So, I had to work Halloween this year. 

Oh, lordy. We all know what this means.... bring on the crazies.

Oh, the strange costumes...

DKA, everywhere...

And offensive "Sexy Nurse" costumes...

And Sexy Nurse References from patients... 

(Don't diminish my profession to a skanky costume!!)

Hyped up Peds Patients....

Strange injuries

And really not wanting to know the answer to the question, "You were injured HOW??"

I guess now we all know the answer to the question, "What would THEY do for a Klondike Bar?"

Of course there's run of the mill drunkenness

 "I'm gonna need a sec and a wet washcloth to figure out if drunken injury or just good costume makeup"

But at least you stayed away from the giant bag of candy in the breakroom!

Just kidding

Happy Halloween, y'all!

You might be a nurse if........

1. You know your personal trainer has nothing on a good round of CPR

2. You've ever sneaked food off a tray delivered to a patient who was made NPO

3. You've ever used small hemostats to pluck your eyebrows

4. You know the difference between real seizures and fake seizures... and you're not amused. 

5. You've totally scarfed down the Panera the drug rep brought and bailed before their presentation.

6. You've experienced that sinking feeling when you walk on the unit and realize the psychotic, screaming patient is yours

7. You called the MD about that psychotic patient and got an order...

 for 0.5 mg haldol IV x1 dose

8. When you have to give the "I mean business" talk to keep a patient in line.

(((pulls curtain)))

9. You've experienced that feeling when the fidgety patient pulls out the IV it took 3 nurses, a venoscope, a rain dance, and a miracle to place. 

10. You know your non-nursing friends will never understand, or experience all the beautiful amazing moments that come with being a nurse:

11. You know the intense feeling of hope sitting by the phone, hoping for "on call"

12. You're not quite sure how to respond when the elderly patient tests positive for an STD...

13. You know the rush of adrenaline that comes with the Trauma pager going off 

14. You love it when a patient says, "I'm a hard stick."

15. Trying not to roll your eyes when the patient's allergy list is ridiculous

16. You really hate it when a patient who's NPO is just dying for something to drink...

17. That feeling when your coworkers offer you up to talk to the Joint Commission Surveyors....

18. You love how good it feels when you are right about a treatment you suggested. 

19. Patient  who's a Full Code tries to die; NOT ON MY SHIFT, YOU DON'T!

20. Doctor comes back to thank you and tell you what a great job you did.....

21. That feeling when the charge nurse gives you the WORST assignment on the unit

22. You have a hard time answering the question "How was your day at work?"

23. When dayshift just doesn't understand what a horrible shift you had. 

24. But you know what you survived with the help of your team

25.  Those moments with a patient or family that make it all so worth it...

No really... the work we do is beautiful! If you're a nurse, thanks for what you do.... if you're not a nurse, go hug one!

For the One who Won't Remember... from your Nurse.

I’ll be honest: When you started getting confused and agitated at the start of my shift, my first thought was, "Oh lordy, this is going to be a long night." The bedcheck went off several times in a row, and the charge nurse immediately called to have a vest restraint brought up from Central Supply. You were so angry with me for requiring you to sit back down, despite explaining that Physical Therapy had ordered nothing beyond stand and pivot with assist.

I looked at you in frustration, then saw you in a moment I can only describe as a gift. I saw, not a senescent, agitated man in a faded gown, but a glimpse into who you were, and still are, beneath wrinkles and a mind that fails you.

You’re frustrated, too, aren't you? It must be frightening to be bossed around by people in a strange place and not know why. 

You don’t want to forget all the reassuring things I keep repeating… that you’re in the hospital… that I’m here to care for you…that you're safe... that I want you to heal… that I am trying to help.

Many years ago, you fought for me on a hill or beach far away. Tonight, I will fight for you, too.

I will fight my frustration, a calloused attitude, and my busy shift and demanding to-do list. I will fight “easy,” which only consists of short verbal redirection and restraints. I will fight for the time to spend talking you through what’s going on rather than being vexed that I need to explain it again.

I will fight against seeing you as a frustrating, forgetful man in hospital issue faded green and think instead of when you wore another green issued uniform many years ago on my behalf.

When you have glimpses of understanding and are saddened by your forgetfulness, I will remind you that you are precious and valued. I will protect your dignity. Though I may smile at the things you say, I will not mock that which you have no control over.

You won’t remember me. You won’t write my name on an HCAHPS survey like the other patients in my group might. You won’t tell your family how much you loved your nightshift nurse. You probably won’t remember me tomorrow, or an hour from now when you reawaken and the process is repeated all over again.  My actions are almost 100% guaranteed to go unnoticed. But for tonight, for this moment, I hope you rest in the dignity of being cared for as one of God’s children, who is of great value.



Based on a shift several months ago, following the loss of my grandfather to Alzheimer's. 
May we all take a piece of this with us as we care for our dementia patients. 

CCRN Life in the Age of Ebola

I can't say that I've ever seen one topic blow up the blogosphere, twitter-land, world-of-facebook like Ebola.

Admittedly, I've more than joined the masses in questioning the CDC, posting about each new case, shaming those who initially finger-pointed at the nurse(s) who contracted Ebola, and pondering what this means for our country and our healthcare workers.

I've shared (and created) my share of Ebola memes:

I've run the range of emotions from "It's going to spread like wildfire," to "Everyone needs to take a chill pill." "Trust the experts," to "I don't think I trust these *experts*" <<insert air quotes here>>, and back to a cautious, "Maybe they're experts again."

So why has Ebola in particular created such borderline mass hysteria? Why is it affecting so many of us at such a personal level, despite the extremely low odds of contracting the disease? Yes, the mortality rate if you get it is crazy high. But I think the thing that gets me is this:

Nina and Amber weren't just doing their job;

They were doing OUR job.

Duncan (US "Patient Zero") could have been my patient, or yours. 

But instead, he was the patient of Nina and Amber, and 50-70+ brave healthcare workers who faced an unknown and intimidating beast because it's what we do. Despite the fact that all the official statements indicate we are at a very low risk of a true outbreak in the U.S., nurses and other healthcare workers dealing with active Ebola are fighting and exposed to the most infectious stage of the disease. We need to be hyper-vigilant about protecting healthcare workers. 

So, I ask myself, what is my response as a Critical Care Nurse supposed to be?

As somewhat of a catastrophist by nature, I recognize I am more prone to a full Hazmat suit even just in full-blown flu season.

But how do we, especially as healthcare professionals, sort through the mainstream and social media to find our way, balancing caution and safety against full-blown paranoia?

1. Be vigilant, not panicked.
2. Be informed. Really informed. 
3. Spread knowledge, not fear.
4. Assess the Ebola plan at your institution, and advocate where you see gaps. Frontline staff may be more likely to see the day-to-day flaws with a plan (i.e. shoecovers, transporting lab specimens, ways to facilitate safe med administration and patient hygiene, disposal of waste) and have creative solutions. 
5. Pray for those affected. Nina Pham and Amber Vinson, the two RNs who contracted the virus caring for "Patient Zero" at Texas Health Presbyterian Hospital were doing their jobs. Our jobs. They deserve our support and not the blame some have ascribed to them. Pray for them, and those caring for them.
6. Trust your gut. When in doubt, err on the side of caution. 
7. Share your creative ideas for safe, compassionate care.
8. On the minuscule chance you care for an Ebola patient, please be careful about your interactions in the days following. 

Remember that the sacred oath, "First, do no harm" applies to our patients as well as to US and our colleagues.

Sending you all Love and Safety!
CCRNLife