Nurse.Com Forums - Blogs http://forums.nurse.com/blog.php This is a Nursing discussion forum. en Sat, 07 Nov 2009 12:14:34 GMT vBulletin 60 http://forums.nurse.com/tangerine/misc/rss.jpg Nurse.Com Forums - Blogs http://forums.nurse.com/blog.php <![CDATA[One Strategy to Support Tomorrow's Nurse Leaders]]> http://forums.nurse.com/blog.php?b=385 Tue, 20 Oct 2009 20:57:40 GMT Although nurse vacancy rates are currently low (due to the economic recession) and nurses are finding it more difficult to find jobs, we are still... Although nurse vacancy rates are currently low (due to the economic recession) and nurses are finding it more difficult to find jobs, we are still facing a severe nursing shortage. According to Peter Buerhaus’ projections, we will continue to experience a shortage of registered nurses reaching 260,000 by 2025.

As our schools of nursing strive to produce new graduates to meet the growing demand, they are stretched to capacity and unable to accommodate all qualified applicants. At last report, 40,000 potential students were turned away. But even more concerning is the fact that 57% of new graduates leave their positions within the first two years. Although nurse residency programs have sprung up to end this cycle of turnover and the National Council of State Boards of Nursing is examining a Transition to Practice regulatory model for new graduates, I have found a simple contribution I can make to develop tomorrow's nurse leaders.

At my alma mater, Virginia Commonwealth University School of Nursing (formerly known as the Medical College of Virginia) I've watched the student population grow from 400 to 1000 while the number of faculty has remained steady. Clearly, there is a need for additional resources and a role for nursing alumni. Recently, the Alumni Association teamed with the School of Nursing to launch the Student/Alumni Connector Program - an innovative program that allows alumni to share their wisdom with students and ease the transition from student to professional.

By creating a “connection” between alumni and students, the program offers an additional resource for students. We understand the pressures of the nursing education program and can provide encouragement and advice in a way that family, faculty, and friends cannot. Alumni serve as their student’s biggest supporter along their educational journey – celebrating major milestones and important dates. Finally, as these students graduate and embark on new professional roles, the alumni community will be there to help them navigate the professional environment.

I am excited to have the opportunity to support tomorrow's nurses. In addition, I am reaching out to you for further ideas, recommendations, and comments to help ensure the success of student nurses and ease their transition into the professional nursing community. I look forward to your comments. ]]> terri_g http://forums.nurse.com/blog.php?b=385 Mercy Me! http://forums.nurse.com/blog.php?b=382 Tue, 13 Oct 2009 23:02:56 GMT Bear with me as I deliver another critical commentary on the latest series starring TV RNs. Nurse Jackie and HawthoRNe were bad enough, but at... Bear with me as I deliver another critical commentary on the latest
series starring TV RNs.

Nurse Jackie and HawthoRNe were bad enough, but at least they aired on cable to a limited audience. Mercy, a prime-time show that premiered Sept. 22, appears on NBC, a major network, free of charge.
The main character, Veronica, played by Taylor Schilling, carries enough personal baggage to warrant a separate series about her emotional life. An Iraqi War veteran with post traumatic stress disorder, Veronica is being treated for depression, drinking too much, mouthing off at work, dealing with an off-again, on-again marriage, living with alcoholic parents, and conflicted about rekindling a romance with a physician she had an affair with in Iraq.
Don’t the networks know there’s plenty of drama in clinics, ORs, EDs, and med-surg units without mixing in the upheavals of the caregivers’ personal lives? What’s more, between Nurse Jackie’s drug addiction and the turmoil in Veronica’s life, the public may start to think that emotional dysfunction is a prerequisite for nursing.
Haven’t NBC’s consultants told the writers and directors that most of us nurses learned early on to leave our problems and worries at the door when we entered the workplace? In fact, I think most nurses find they have little choice. Our patients and their families demand our full attention. We don’t have the time or inclination to dwell on our own troubles when we’re at work.
Not so for Veronica and her colleagues Sonia and Chloe and nurse characters on other shows. Husbands, partners, sweethearts, and children come bursting through the doors of EDs and patients’ rooms once or twice an episode.
And another thing —the nurses I know certainly don’t talk to patients as sarcastically as Veronica did in episode one of Mercy. When her 60-year-old patient with advanced carcinoma of the liver asks: “What are nurses good for,” Veronica retorts, “Well we do try to stop the doctors from killing you.”
Like every nurse with a few years in the trenches, I’ve had my share of disagreements and run-ins with doctors, but I’m already tired of the nurse TV show formula in which physicians are portrayed as egotistical snobs and nurses as smarter than the MDs and always right.

Maybe it wouldn’t irritate me quite so much if I thought the network was peddling pure fiction, but from the statement on NBC’s website about Mercy, it sounds as if the network thinks it’s giving us a close-to-reality show. The statement reads: “The stories of Mercy come from real life nursing — and the issues explored in the show reflect a spectrum of contemporary health issues. To help the public better understand the implications and intricacies of the show’s themes, this outreach page [on the Web] has been created with the assistance of the Hollywood Health and Society group at the University of Southern California’s Annenberg Norman Lear.” (See www.nbc.com/mercy/about/resources.)

So my fellow nurses, watch an episode or two, then limber up your emailing fingers, and tell NBC what you think. There’s much more not to like than I could fit into this short critique. Send comments to:
Take pity on the men and women of the viewing public who could easily find themselves in a hospital bed some day. After watching Mercy, they might think they’ll meet up with a Veronica, Sonia, or Chloe.
Tell NBC to call the rewrite team in stat. We owe it to ourselves and our patients to speak up. ]]> JudithMitiguy http://forums.nurse.com/blog.php?b=382 <![CDATA[Carolyn's Battle with Breast Cancer]]> http://forums.nurse.com/blog.php?b=377 Wed, 07 Oct 2009 21:45:16 GMT When I think of Carolyn, I remember her smile and her courage. Hobbled by breast cancer for years, it could not suppress her spirit. I think... When I think of Carolyn, I remember her smile and her courage. Hobbled by breast cancer for years, it could not suppress her spirit.

I think about her especially during October-- National Breast Cancer Awareness month—when we are reminded once again by the National Breast Cancer Foundation of how important early detection is.

Carolyn was my brother-in-law’s older sister. I had long admired her when I was growing up in our small town in Iowa. In my eyes, Carolyn had it all. She was vivacious, smart as a whip, attractive, and accomplished. The fact that she was three years older than me added to my sense of awe.

Carolyn lived with cancer as if she were disease- and pain-free. She ran her business as the publisher/editor/writer/proofreader/go-fer of a small-town newspaper up until the end. Whether it was organizing a parade, traveling the world, loving her family, or laughing with her friends, nothing—not even cancer—stopped her.

I remember the last time I saw Carolyn. The cancer had metastasized to her bones and the pain was excruciating. Her feet and legs were shriveled and purple, but she still retained that indomitable smile. Her trademark curiosity and intellect still perked within, even as her body betrayed her.

Meeting for the last time, she showed me a newly framed photo. There was Carolyn, decked out in leather pants and motorcycle jacket, perched on a Harley Davidson. Her hair had been spiked and dyed blue by her friends, who had taken this photo, proclaiming it to be “the real Carolyn”.
That photo exemplifies how I remember Carolyn. Despite the “nuisance” of breast cancer, she lived her life with gusto and flair.

As nurses, I think most of us have been touched by the scourge of breast cancer, just as Carolyn’s struggle affected me. But, as nurses, who is better than we are to advocate for early detection? We need to tell the world that breast awareness through education, breast self exam, and mammograms can make a difference in length and quality of life.

The world has lost too many Carolyns for us not to do something to curtail this dreaded disease. Not only in October, but all through the year, let’s be aware that early detection of breast cancer can save lives. If we can save even one person from what Carolyn endured, either directly or indirectly, we will have succeeded.
–––––––––––––––––––––––––––––––––––––––––––––––––– ––––––––––––––––––––The National Breast Cancer Foundation, Inc is a charitable non-profit organization based in Frisco, Texas. Its campaign every October, National Breast Cancer Awareness month, is their effort to promote its Early Detection Program. NBCF’s mission is to save lives by increasing awareness of breast cancer through education and by providing mammograms for those in need.
__________________________________________________ _______________________________________________
As the most trusted of all professionals, people come to nurses with questions about cancer. Do you have the answers?

Check out the continuing education modules below to update yourself on the latest findings in detecting, treating, and managing cancer.

http://ce.nurse.com/60020/Navigating...ancer-Journey/

http://ce.nurse.com/CE479/Genetics-S...sing-Practice/

http://ce.nurse.com/CE85-60/Advanced...sment-Breasts/

http://ce.nurse.com/CE295-60/Psychol...s-with-Cancer/

http://ce.nurse.com/CE342-60/Cancer-...al-Antibodies/

http://ce.nurse.com/60075/Cancer-and-Chemotherapy/ ]]> pammer http://forums.nurse.com/blog.php?b=377 Life after getting my BSN http://forums.nurse.com/blog.php?b=370 Mon, 05 Oct 2009 23:24:59 GMT I graduated from an ADN program in 1982 at the age of 30. I had four children from ages 12 to 3. It was a stressful time for me. Trying to make good... I graduated from an ADN program in 1982 at the age of 30. I had four children from ages 12 to 3. It was a stressful time for me. Trying to make good grades, completing all the homework took up so much of time I felt guilty for the time I lost with my children. I then went to work a month after graduating in the Emergency Room. This was my not idea, but the Director of Nurses decided I "looked like I would do well in the ER and cross train in ICU" I was in shock, but too intimidated to voice my concerns. But it turned out all right, I functioned well and was made team leader after six months. But after dealing with death of patients of all ages on a daily basis started to effect my family life. I become overprotective of my children. I would not let them ride their bikes unless I was home and could watch them, they could not climb trees, I tried to talk my daughter out of playing softball. My fears were interfering with my childrens' childhood.
So I transferred to Acute Rehabilitation where I fit in and did a good job, but after 16 years and multiple broken bones and back condition which required surgery (I have osteoporosis), the constant heavy lifting took its' toll. I quit in 2002 and planned to take a break for a couple of months, but one of my worst fears occurred that October. My 26 year old daughter was found dead . No cause was ever determined by the Medical Examiner. Needless to say I was overwhelmed with grief that did not resolve for 2 years. Meanwhile I was unable to return to work as I could not concentrate and would break out into tears without warning. I did take a Forensic Nursing Certificate Program from Kaplan College and trained as a Sexual Assault Nurse Examiner and performed rape exams occasionally.
I finally entered the job market by getting a job at a ER in Tahlequah which I felt totally out of place. The staff were mostly young and unfriendly. The doctors spent their time on the internet and griping when we had patients, they wanted them triaged as fast as possible so they could do their part and the rest was left to the nurses to get them out as fast as possible. They never had anyone who was in charge. My director was always calling me in for something another staff member had complained about, some were completely untrue. He was never around so he assumed that they would not lie. Anyway I decided I would go back and get my BSN and get a job that did not require physical tasks and pursue a job which was not in a hospital. My last job was as a DON which took almost all of my time and the time left I spent on online classes and outside projects required for each class. I quit in 2008 to concentrate on my last year in school.
During this time I had a second back surgery which still has not healed. I am trying to find work that I am interested in and something that I feel can make a difference. But I am having some difficulty finding a position. I have sent out resumes on the web and to public health advertisement but I have not received any interviews. ]]> raydelleh http://forums.nurse.com/blog.php?b=370 Flu shots http://forums.nurse.com/blog.php?b=367 Sun, 04 Oct 2009 04:43:21 GMT Been crazy busy with adminsitering hundreds of flu shots for young and old. More facilites mandating shots for the students too. We are almost out of... Been crazy busy with adminsitering hundreds of flu shots for young and old. More facilites mandating shots for the students too. We are almost out of in-active and cannot order more because they are working on H1N1. The rest will have to wear masks for clinicals. We do have plenty of live FluMist left. I took mine about 2 weeks ago, gave to my husband, grandaughter, mother, sister, and grandfather. My sister said her arm was sore for 2 days. No one else in family had any reactions. Out of the patient population only had one person who ran a fever for 3 days and had muscle aches and he was a post spleenectomy pt whose MD made him get the shot. Hope everyone is having no problems either. ]]> NurseEducator http://forums.nurse.com/blog.php?b=367 Bump or Shake? http://forums.nurse.com/blog.php?b=366 Fri, 02 Oct 2009 17:33:29 GMT Advocates for preventing swine flu transmission are suggesting a hand bump instead of a handshake. Fine. But in my mind, this presents many questions... Advocates for preventing swine flu transmission are suggesting a hand bump instead of a handshake. Fine. But in my mind, this presents many questions and the huge potential for social dilemmas and discomfort.

We all know the hand bump, seen often on the athletic field. It’s bending the arm at the elbow and raising the wrist to knock knuckles with a similarly close-fisted colleague. That works well on the football field as an expression of mutual acknowledgment for a job well-done. I’m not so sure how it will play in the business and social worlds most of us inhabit, though.

OK. Say we don’t shake hands anymore because that will spread germs. That leaves hand bumps or doing nothing at all as our choices.

Let’s take the hand bump route. I cant visualize just meeting someone new and then raising my fist as if I am about to punch them. I wonder if their reaction will be to duck. Just imagine someone coming at you with a smile on their face and a raised closed fist. Does that seem friendly—or scary--to you?

Also, isn’t the hand bump a little too sporty, frivolous, or even light hearted for most situations? Would you greet another person in a serious situation, such as a new patient, with a hand bump? Well, maybe a 10 year old. But what about his grandmother? What about family members coming to see a very sick patient? Would you hand bump your boss? I have my doubts that a hand bump could ever be a sincere and professional greeting.

Let’s look at what happens if we choose not to offer our hand for a handshake. We might seem cold, aloof, or unfriendly if we don’t extend a hand. We could explain we don’t want to spread disease, which may either offend or scare the other person. It might even make them wonder if we are a clone of Howard Hughes, the eccentric and notorious germaphobe.

Meanwhile, if we don’t offer our hand in our effort not to spread H1N1, what happens if the other person has not gotten the message and extends their hand? In their mind, it's not good if we dont follow through and complete the act. Just think how embarrassed, offended, or awkward someone will feel once their handshake has been rejected.

Of course, for infection control purposes, we wont want to touch someone who wants to shake our hand, but does that mean we should pump hand sanitizer into our palms immediately if our hands make contact, either after shaking hands or even post hand bump? If this were an ethics decision, deciding on the side of doing the greater good would be to do just that—sanitizing after fraternizing. After all, we don’t want to either spread of receive a contagious infection, do we? We just need to be aware how this will affect our business and social relationships.

To hand bump or not; to abstain or not—that is the question. And there are no easy answers. Whatever happens, there will be embarrassment, awkwardness, and misunderstandings.

And I wont even begin to talk about the infection potential generated by social hugs and kisses. Handshakes are as far as my mind will let me go. Anything more gives me a headache. ]]> pammer http://forums.nurse.com/blog.php?b=366 How to Eliminate Bullying in our Workplaces http://forums.nurse.com/blog.php?b=358 Fri, 18 Sep 2009 16:51:17 GMT Representative Joe Wilson’s outburst during President Obama’s address to Congress, Serena William’s explosion of anger on the tennis courts at the US... Representative Joe Wilson’s outburst during President Obama’s address to Congress, Serena William’s explosion of anger on the tennis courts at the US Open, and Kanye West’s interruption of Taylor Swift’s acceptance speech at the MTV Video Music Awards have prompted lots of discussions about civility.

Those of us in healthcare have long experienced incivility and even bullying in the workplace. I have experienced my share of (a) being shut out of the clique, (b) being excluded from conversations, (c) being the topic of gossip on the unit, and (d) being subjected to obnoxious physicians. I have even witnessed temper tantrums thrown by various members of the healthcare team. It is time we recognize the cost of this behavior to us as individuals and to our organizations and put a stop to it.

“Rudeness in our workplace results from and causes uncivil attitudes and behavior in our larger culture,” write Christine Pearson and Christine Porath in their new book, The Cost of Bad Behavior: How Incivility is Damaging Your Business and What to Do About It.

Bad behavior has a cost to us as individuals and to our organizations. Individuals exposed to incivility and bullying may experience physical symptoms such as weight loss, headaches, and difficulty sleeping eventually leading to a drop in self-esteem and job satisfaction. According to Pearson and Porath, organizations bear the cost of disruptive behavior through lost productivity (work hours lost to worrying and avoiding the bully), increased healthcare costs (due to stress), and replacement costs when employees leave in order to escape bullying.



We can bring civility into our healthcare environments and eliminate bullying. Here are four tips adapted from "Stop Bullying in the Workplace."
  1. Be mindful of your own behaviors – Don’t participate in bullying activities.
  2. Know your hot buttons – Become aware of what behaviors to which you are particularly sensitive.
  3. Prevent the spread of disruptive behaviors – Step in when you see others being bullied.
  4. Practice constructive conflict behaviors – Empathy and reflective thinking are examples of proactive behavior.
]]> terri_g http://forums.nurse.com/blog.php?b=358 Meet Me at the Mosque http://forums.nurse.com/blog.php?b=353 Thu, 10 Sep 2009 20:43:18 GMT Last night, I was a guest at the mosque I drive by every day on my way to and from work. Long shrouded in mystery, I was able to see and experience... Last night, I was a guest at the mosque I drive by every day on my way to and from work. Long shrouded in mystery, I was able to see and experience what goes on there and – yes – even become a part of it.

My Muslim friend, an RN, had invited me to the religious observance of Iftar, the communal evening meal that occurs after the sunup-to-sundown fast every day during the Islamic holy month of Ramadan.

Gihan did not arrive right away and I was early. Swathed from the top of my head to wrists to floor with yards of fabric to show modesty and respect while in the mosque, I waited awkwardly for her outside the mosque, futilely trying not to call attention to myself.

It turns out it was a good thing she did not come right away. This gave me the unique opportunity to see the Muslim people in my community go about their routines, as they gathered together for socializing, praying, and breaking their day-long fast.

As I waited, I heard children—just like children everywhere-- screeching in delight as they raced around the playground. I listened to boys dressed in their karate outfits talk about playing cops and robbers, a game that brought back memories from my own past. Mothers and fathers tended to their children and women laughed and chatted with one another. Men greeted each other with high fives and joked among themselves.

At last, the sun went down and it was time to break the fast before going into the mosque for a short prayer service before dining.

Seeing I was alone and a stranger, two older women made a point of approaching me and offering dates from their package, traditionally the first thing to be eaten at sundown. Others expressed a friendly welcome and thanked me for visiting their mosque. Several young women wanted to lend me their cell phones when they learned I was waiting for a friend.

Nods and smiles greeted me everywhere I turned. I felt welcomed and nurtured.

I marveled at the previously-unknown, exotic setting that I drove by twice a day and at the exotic group of people in front of me—different clothes, different languages, and different customs. Yet somehow, I had witnessed tonight’s scene hundreds of times before.

Happily, I found Gihan. More important, I found and recognized once again what I have always known as a nurse: No matter the setting or the group, people are people and our similarities are greater than our differences.

My visit to the mosque also gave me a better sense of my own community by allowing me to know more about the Muslims who share it with me.

I hope others will have the same opportunity to discover what I did and to treasure the experience, as I do. It will make us all better citizens, people, and nurses. ]]> pammer http://forums.nurse.com/blog.php?b=353 Shift Work Creates Discontent Among New Nurses http://forums.nurse.com/blog.php?b=347 Tue, 25 Aug 2009 20:02:01 GMT With a year of experience under our belts, a nurse colleague and I relocated to begin a new phase of our professional careers. The year was 1982,... With a year of experience under our belts, a nurse colleague and I relocated to begin a new phase of our professional careers. The year was 1982, nurses were in demand, and we could set our own schedules. Several facilities offered us good positions but we turned them down thinking that we shouldn’t have to rotate shifts. After three months of unemployment we changed our minds.

Working as a staff nurse, I lost count of how many family dinners, holiday gatherings, and other events I missed because of my work schedule. Trying to balance my work schedule with my personal life was a constant source of frustration. Certainly self scheduling has been an improvement but still – there has to be a better way to minimize the impact of shift work on our personal lives.

A recent article by Pellico, Brewer and Kovner in the July/August 2009 issue of Nursing Outlook shared some interesting reflections of newly licensed registered nurses. Within a year of joining the ranks of the RN workforce these nurses noted that the effort to balance the demands of work with family and leisure time contributed to a sense of discontent with their career choice.

A study of new graduate nurses in Australia by West, Ahern, Byrnes, & Kwanten published in Collegian also raises this notion of discontent. Their study found that of all the negative consequences associated with shift work (sleep disturbances, health implications, and depression) the disruption in social interaction was an important factor in new nurses leaving their positions.

With turnover rates of newly licensed nurses reported to be as high as 70% in some instances, the struggle to achieve work/life balance is an issue we cannot afford to ignore. We must re-examine our deeply rooted views of shift work and reform the system to meet the needs of all parties – employers, patients, and nurses. Meanwhile, helping novice nurses select shifts that fit with their personal needs is one way to reduce the disruption of shift rotation on their social lives and retain them in the profession. Are there best practices you would like to share? ]]> terri_g http://forums.nurse.com/blog.php?b=347 Transitions http://forums.nurse.com/blog.php?b=346 Sun, 23 Aug 2009 22:01:11 GMT Hello Fellow Nurses, Sometimes in life everything goes smooth. Othertimes, the road is rocky and we find ourselves in a state of transition. I... Hello Fellow Nurses,
Sometimes in life everything goes smooth. Othertimes, the road is rocky and we find ourselves in a state of transition. I recently moved my mother and grandfather in with me. Things in general are going well but, he is experiencing some new confusion that has never occured before and 2 weeks ago grandpa fell making the transition from the foyer to the living room. So, x-ray and MRI later he has hairline pelvic fracture. So, though parts of me is excited about the ability of our family to face a move from another city and add 2 generations to our household. Another part is wondering if we did the right thing in moving a 97 year old man from the home and city he knew so well. At any rate, all we can do is plan and pray. The rest is not up to us and we are infinetly better accepted the wisdom and way of one for wiser than us. So as you weather your transitions whether in your family or career that is what we must all do. Plan and Pray. ]]> NurseEducator http://forums.nurse.com/blog.php?b=346 Making Your Pain Doctor A Partner http://forums.nurse.com/blog.php?b=343 Mon, 17 Aug 2009 01:33:55 GMT I saw my Pain Management Doctor last week. It is time for a medication change due to my ever-increasing pain. I don't take medication changes lightly; the process can be particularly non-pleasant at times, depending on what you are doing with the change. This decision has been awhile coming, right alongside the pain that just keeps coming. My choices are few. I need a partner to help me with this.


Enter the kindest, most professional, (without being like a robot), empathetic, with an 'I want so much to know what you feel when you tell me of your pain' look in the eyes; Pain Management Doctor. It was time to get down to business as we began. We consistently have a nice time together; we talk well. You know 'those' kinds of doctors?? I was married to one, {gasp} and feel that he is such a kind, caring, thorough and empathetic doctor, whose patients just adore him. We'd get the most wonderful gifts at Christmastime; mmmm fresh Persimmon cookies from one lovely patient--every year like clockwork, I was faced with a huge tin of the best cookies I have ever tasted, and what is a girl supposed to do?? Admire them? Ahhh NO, I made great use of them!! Point is that doctors whom patients can talk to, and feel deeply heard by, is the key to the successful partnership of the doctor-patient relationship.


My doctor and I worked together to come up with what to do as far as what medication to change, and when we figured out which one, it was up to me in the end as what to do. This is the #1 most important attribute that we, as pain patients, simply must have with our doctors. The ability to work together on any part of our pain management care.


When you visit your pain management doctor, the feeling in the room is ultimately that of teamwork. Talk together. Figure out what you are trying to accomplish first and foremost during that visit. Remember, come prepared!! Help your doctor out a bit too. I brought my daily medication log, jotted down the monthly 'total' of how my pain had done over the time since I last saw my doctor, and that helped so much in my visit.


I spoke with my doctor about feeling that deep pain the most when I stand up, and that I felt as if I would benefit from 2 rods in my back, long enough to cover 12 levels, (all the Thoracic vertebrae), and he said, "You feel unstable in your spine?" Yes!! That was perfect! The word described exactly how I feel in my spine. And it's a great medical term to put down in my chart.


It is through our talking, getting to pinpoint exactly what we are there to do: Accomplish solving a problem. And for that, we all need ourselves and another person who will talk openly, honestly, seriously, and with an attitude of doing it together.


I could never do this myself. I know what to use, how to take it and how to titrate up or down. Nursing and years of pain have taught me this. Options for complete medication change are not many in the pain arena. Then there is the how to change it when things need to be altered. I knew the options available to me, and therefore, had been considering them days before the doctor visit. This made the decision simpler, faster, and more of a feeling of unity when my doctor totally agreed at what I chose to do.


My spine feels unstable. Great word doc! Today is one of those days when the pain is constant, unrelenting, deep, with neuropathy (**nerve pain), and severe muscle spasms. My back has gone through a real workout, and the paraspinal muselces, (**the muscles that run along your spine in the vertical position) are now extremely tight. When I stand up, my back says, "I don't want to be in this position." I am compacting my spine, yet laying down is not an option. I must SIT, and always against heat. Yes, yes, I've tried heat for 20 minutes and cold for 20. That was more effective when I was recovering from a surgery. But now I speak of what works for pain that lasts all day sometimes, with no relief, such as today has been. The cold and hot are long gone as I have found that heat is the only relief, modality-wise. (Modality--**A method of application or the employment of any therapeutic agent.)


In an office visit, we are all aware that time is, and always will be an issue. In any medical exchange. Yet there are time issues with those on the phone, your appointment to have taxes done, your haircut; oh it would be nice to have the person you are working with spend as much time with you as you'd choose; but we all know it just doesn't work that way!


Ergo, (wow I really don't like that word, but it is a good one!), why I make the most out of the time with my Pain Doc, by bringing daily notes and things that jog my memory. The relationship with your doctor needs to be one of openness, almost like one you'd have with a psychologist. The doctor needs to know everything you feel, every medication you are taking, if anything as in a fall or accident has happened, and just to cover everything that could have precluded the increasing pain. This needs to be talked about with precision and knowledge, as serious decisions are involved.


This is your partnership. This is your LIFE! Work on having a close, open, honest, respectful relationship with your Pain Management Doctor. Above all, work on your own side of this partnership, by keeping a pain journal, pain log, whatever works for you. Be kind to yourself, respect your doctor just as she/he respects you as a person, and I wish you the best of care for your pain.


It takes two!!



Gentle Hugs... <3 ]]> makeupgal http://forums.nurse.com/blog.php?b=343 Nurses are finding their voice http://forums.nurse.com/blog.php?b=340 Wed, 12 Aug 2009 17:21:00 GMT In the early 1990s, I found myself driving an ambulance across the country as part of a promotion organized by Families USA (a Washington, DC based... In the early 1990s, I found myself driving an ambulance across the country as part of a promotion organized by Families USA (a Washington, DC based consumer health organization) to promote the need for healthcare reform. As the lead driver of one vehicle in the 12 ambulance caravan, I crossed the nation hosting rallies in metropolitan areas to raise support for the need for health reform. After several weeks, the caravan converged on the US Capitol where our final rally was held.


Eighteen years later, healthcare reform is again on the national agenda. While much is the same, such as advocacy groups spending millions in media campaigns, much has changed. The Internet has made the debate more interactive and accessible. Through blogs, Tweets, Facebook, YouTube and news sites everyone can share their views and get real time updates. As the debate unfolds, I am fascinated by the innovative ways in which nurses are mixing old and new technologies to voice their opinions.
  • I can find out what Michael Knapp, RN, Executive Director for the Emergency Medicine Trauma Services at Children’s National Medical Center in Washington, DC had to say after he participated in a healthcare roundtable discussion with President Obama.
  • Finally, I can obtain a global perspective from colleagues around the world via sites such as Nurses for Reform.
Had I been able to Tweet during my ambulance drive 18 years ago, I can only imagine the impact our efforts would have had on advancing health reform.

There are many ways our voices can be heard and I encourage you to take the time to share your views on this important issue. Whether you send a hand written note to your legislator, take part in a Facebook group or comment in an online discussion; join the growing numbers of nurses sharing their thoughts and views. Then drop me a note and tell me how you found your voice. ]]> terri_g http://forums.nurse.com/blog.php?b=340 can I be a nurse http://forums.nurse.com/blog.php?b=335 Mon, 10 Aug 2009 20:25:06 GMT Hi everyone, I am going to ask a question and if anyone can help out it would be much appreciated...... I want to be a nurse but when I was 18... Hi everyone, I am going to ask a question and if anyone can help out it would be much appreciated...... I want to be a nurse but when I was 18 yrs. old I got in some trouble and I have a felony on my record....I am 23 now, so its been 5 yrs since I got in trouble....Will I be wasting my time going to school for nursing or am I able to get a job as a nurse? I have no clue what type of rules or restrictions there are for someone like me that has been in trouble... any answers or help is appreciated thanks ]]> taylor241824 http://forums.nurse.com/blog.php?b=335 <![CDATA[Payscale for RN's in Philadelphia hospitals]]> http://forums.nurse.com/blog.php?b=334 Mon, 10 Aug 2009 14:46:03 GMT Hi! Hope someone can help me... I would like to know the payscale for nurses at HUP, Pennsylvania Hospital and Jefferson hospital and other area... Hi! Hope someone can help me...
I would like to know the payscale for nurses at HUP, Pennsylvania Hospital and Jefferson hospital and other area hospitals. I am considering moving to Philadelphia (family reasons) from NYC and would appreciate if someone can help me out. Human Resources at these hospitals do not give out any info when asked. I have been a nurse for 2yrs on a surgical floor. Also, would like feedback on what areas/units /hospitals are good to work. I am considering Recovery Room / ER. But any feedback would be of much help. I prefer to not do bedside nursing, so if anyone has any feedback, suggestions will be much appreciated. Also, what is the patient-nurse ratio/load. The answers you get from Human Resources varies so much when asked about details, and so I decided to post on here to get honest and true opinions/suggestions from nurses working in Philadelphia hospitals/units. Thank you very much. I do appreciate it. ]]> susie921 http://forums.nurse.com/blog.php?b=334 Annie Oakley Rides Again - TV Nurses and the Wild West http://forums.nurse.com/blog.php?b=333 Fri, 07 Aug 2009 14:27:18 GMT I’m confused. Don’t TV producers know that for the last seven years nurses ranked number one in Gallup's annual Honesty and Ethics of Professions survey?

The two nurses they introduced to us this spring definitely don’t fit the profile of top-notch professionals. Showtime’s Nurse Jackie and TNT’s Hawthorne walk on the wrong side of the law or disregard ethics guidelines at least once an episode. Still, I hear many nurses and lots of other TV viewers really like these characters. My hairdresser says he loves Jackie.

Played by Edie Falco, Nurse Jackie is a drug-addicted emergency nurse who is one year into an affair, at work no less, with a Percocet-supplying pharmacist who doesn’t know she’s married to a devoted husband and has two young children. For Jackie, assisted suicide, lies, pill popping, and retribution are all in a day’s work.

Christina Hawthorne, depicted by Jada Pinkett Smith, plays a hospital’s chief nurse, who seems to do everything but run the nursing department. She intervenes in all crises, diagnoses rare diseases, and even resuscitates patients after the physician in charge has ended the code. She’s super nurse. But Hawthorne, as she calls herself, defies the limits of ethical and sometimes legal professional practice when it suits her purpose. Plus, she’s aggravating. She micro manages every situation.

Those of us concerned about nursing’s image in the media are more than unhappy with these programs, and I haven’t even mentioned the cavernous gap between reality and the clinical situations.

I’ve been forcing myself to watch these shows every week to try to make some sense of them, and I’ve come up with a hypothesis — Nurse Jackie and Hawthorne are the new westerns —Jackie and Hawthorne the new cowgirls, flawed but courageous, defending patients, battling and outsmarting the healthcare system instead of capturing stagecoach bandits.

With both these nurses, no matter what it takes, be it illegal, unethical, rude, or beyond defiant, they morph into heroes when they’re advocating for patients and families. They work around over and way outside the system to get what’s needed, especially when the patient is critically ill, emotionally out of control, or destitute. They move mountains, in the form of chief surgeons, CEOs, police officers, and insurance companies for their patients.

These cowgirls, one in scrubs, one in a white coat, know how to hold a patient’s hand, break bad news to families, hug a child, respond to trauma and mental health emergencies, and help a patient die with dignity.

We know from experience that our agenda related the image of nurses and a TV producer’s vision are miles apart, but maybe these shows aren’t just about nurses after all. They seem to tap into America’s frustration and cynicism with healthcare in the United States and with the so called corporate bureaucrats and reams of red tape people resent and fear.

Maybe Jackie and Christina are the Lone Rangers of the 21st century, fantasy figures, flawed just like the cowboys of old, abiding only by a law they’ve create for themselves. Maybe the public likes the way they ride roughshod over the establishment and stand by their patients.

Of course, Nurse Jackie and Hawthorne certainly aren’t going to change my opinion about ethical nursing practice, but I will be watching the shows with a new set of eyes and listening even more attentively to the news on healthcare reform. ]]> JudithMitiguy http://forums.nurse.com/blog.php?b=333