Wednesday, August 29, 2012

I'm Sexy and I Know It

  The last shift in the ER I was working with one of my favorite PA's. He's the "no bullshit" kind of guy who has a ton of sympathy for anyone with a real complaint, but anyone looking for a refill on their Dilaudid isn't going to get very far with him. No Bullshit has a dry, sarcastic sense of humor that matches nicely with mine so when we work together we make one hell of a team.

  That night we had a fellow in with an injury to his male organs that was truly legit. No Bullshit ordered an application of a numbing agent to the effected area. As I was pulling the stuff out he looks over at me and says; 

  "Hey you want to give that over to one of the guy's?"

  I look at him a little confused, "I'm a nurse I can handle looking a a guys thingy."

  He laughs, "Yeah well how about we make the fellow feel more comfortable? It's kind of embarrassing to have that kind of injury and then to have a hottie nurse handling your junk."

  "Oh I'm a hottie am I? Is that what you think of me?"
  "You're a hottie and you know it. Now go give Grandma over there a shot of antibiotics."

  This is why I love working with No Bullshit, 
we always end up having a good laugh.
"I'm too sexy for my scrubs."

Tuesday, August 28, 2012

Paging Dr. Grumpy

 "Page the Doctor." 

  The three words that seems to strike fear into the heart of every new nurse. In nursing school I cannot tell you the number of time that when the teacher said;
  "You'll need to call the Doc if this happens."
  "But what if he yells at you?" someone in the class would pipe up and ask every time.

  Why is this the gut reaction of every new nurse? Are doctors really terrifying creatures that put on a human skin when they come out of the lounge but in reality are snarling beasts when there are no prying eyes to see? Or is it that every doctor has an inner ear condition that is painfully exacerbated by only the exact pitch of the cell phone or pager ringer that sends them into a fit of pain induced rage when ever a nurse calls?

  All kidding aside, as a new nurse I have found it daunting to call a doctor, especially in the middle of the night. I don't like talking to some disembodied voice, that I have no face to attach to. In the end I did have to get over this irrational fear of talking to doctors, what helped me through this phase was to have a formula when I called the Doc.

  Remember SBAR? Yes it felt like I was pulling that one from the depths of my brain, but I guess they taught it to us for a reason. A charge nurse suggested that every time I contacted the Dr I should write my report down in SBAR fashion so that it was organized and I had all my information in front of me. OK for those of you who have forgotten lets review.

  SBAR stands for SITUATION, BACKGROUND, ASSESSMENT and RECOMMENDATION. This format is often used in giving report to help the nurse give a full picture of the patients status in a short, concise manner to someone who would not be familiar with them. Let's face it, Dr's see hundreds of patients everyday, if you just call them about Mrs Smith it might be the eighth Mrs Smith they have seen, you need to give them enough to jog their memory about the patient so they can make the right call. SBAR report may be awkward in the beginning but with enough practice it will become second nature.Here's a little taste of how it often goes.

 "Dr. Grumpy, I'm calling about Mrs Smith. She is a 57 yr old female who came to us with sepsis, since 8pm her BP has been going down and now I notice she has inadequate urine output. (That is your situation) She has a history of CHF and hypertension. (This is the pt's background, don't give a life story just what is relevant) Right now her BP is 80/45 and she is tachycardic at 110, with only 50mL urine output in the last 2 hours. (Your assessment) Would you like me to give a bolus of normal saline and start a pressor of some sort?(Your recommendation)" 

  If you read that aloud you'll notice it took under 5 minutes and gives the Doc a nice picture of whats going on in your neck of the woods. Not only have you clearly stated the problem that you are calling about but you have given the Doc enough info to make an informed decision. Here are some other tips:

  • Keep the patients chart open near by, the Doc may want to know the most recent labs. This way you are prepared, not fumbling around, they appreciate that.
  • Take five minutes and write your SBAR down so you have everything you want to say in front of you. I have blanked a couple of times when the Doc got on the phone, it saved my butt!

  • Don't take is personally if you do get a cranky Doc, they are people too and like us nurses can have bad days. Just be polite, get what you need and hang up, then vent to your fellow nurses, no point getting too upset over it we have more important stuff to attend to!
  When a patient starts to take a turn for the worse it can often be pretty scary especially for a newbie. The best advice I ever got was from my charge who reminded me that a patient rarely goes downhill so fast that you can't take a minute to organize yourself. Taking a second to clear your mind and focus on all the important things not only improves your patient care but will also make communicating with those Doctors even easier.

Monday, August 27, 2012

A Few of My Favorite Things

  It doesn't take much to make me happy.
These are just a few things that I have found lately that make me happy,
very happy!
Let me tell you about them.

A. Tresemme Fresh Start Dry Shampoo : I never used dry shampoo before because generally the only place you could get the stuff is at salon or prestige counter at the beauty supply store and at an average of $20 a pop I was not going to indulge that much, I could use shampoo, the wet kind, thank you very much.
  But wait! As I was walking through Target, I spied this product in the hair care aisle, priced at under $6.00 I thought I would give it a try. 
  Why does it make me happy? Because I have pretty oily hair that needs to be washed every day. In the past I have been showering when i get home and then when I get ready for work, that's tough on the hair, especially if you have color in it. Now I just shower when I get home, go to sleep and apply this stuff to my hair when I get dressed. It keeps my hair looking clean and oil free for my 12 hour shift, and it smells clean and pretty.

B. Mio Liquid Water Enhancer : Look in my work bag and you will always find at least two of these rattling around in there. These little bottles take up no room and are perfect for masking that nasty taste of hospital water. Because they are liquid they mix right in to ice cold water unlike those drink crystals which take forever to dissolve and often result in a thick concentration of flavor at the bottom of your cup. Blech!
  These guys make me happy because I can adjust the flavor in my water to how I like it. I like my flavor kinda light, Mr likes his full of flavor. Even better these Mio's also have an energy formula if you want a quick boost but don't feel like reaching for a cup of coffee. I mix the flavors through out the night too!

C. Therafirm Compression Socks : You can quit snickering, yes I wear compression hose and yes it makes me happy. These light weight trouser socks apply medically correct pressure to the legs in a gradient that prevents blood from pooling, resulting in less tired, achy legs after 12 hours of being on my feet. Don't wait until you start having problems like varicose veins, or swollen ankle before you decide to get a pair. Get a pair NOW and prevent these problems, it's called preventative medicine nurses!

D. Pedi-Scrub Foot Buffer : We beat up our feet, spending 12 hour shifts on them while shoved into hot sweater shoes. These little scrubbers show your feet some love! They come in two scents Citron Eucalyptus and Lavendar Tea Tree. These little flower shaped scrubbies are impregnated with moisturizers and cleansers, the dual sided sponge has a scrub side for exfoliating your feet, the sponge side bathes your feet in all the foamy good stuff. 
  I started using this foot buffer everyday, after a week I noticed my feet were way softer and smoother. This is how I keep my feet looking presentable between pedi's!

These are a few of my favorite things,
what are a few of yours?

Wednesday, August 22, 2012

I'm a Nurse

When I arrive for shift and 
they tell me they have brought in a nurse 
to cover my assignment in the ICU so I can cover 
in the ER because they are down a nurse 
I wonder...
Why the hell did I offer to float in the first place?

When the A/C goes down in the middle of the night 
and the whole hospital heats up to 90 degrees
I wonder...
Why didn't I call in sick like I wanted to today?

When the crazy patient pulls out her foley 
and then pee's on all over the bed 
and my arms as I try to get another one in
I wonder...
Why did I sign up for this job?

When a patients family comes in the doors to tell us 
that he is recovering upstairs on 
the Tele floor, gives us hugs all around 
and says thank you 
for saving their loved ones life
I know...
This makes everything else worth it.

Yep, I'm a nurse, and I wouldn't trade it for anything else in the world.

Tuesday, August 14, 2012

Being a Nurse Has Made Me Better At....

  I used to roll my eyes every time one of my instructors gave the class the "nursing isn't just a profession  it's a lifestyle" speech. Right, how on earth was learning about drip rates and lab values going to change my life? Amazingly they were right, here are a few ways being a nurse has changed my life.

I used to be the worlds worst cook. Honestly, ask my husband, I have given him food poisoning on several occasions. My cookies always came out looking like tiny cakes and my cakes came out flat as a pancake. 

  So what changed? First, I finally have a handle on measurements, Remember all those seemingly pointless conversions they made us do in first semester, how many teaspoons are in a tablespoon, how many mL's are in an ounce? Now instead of trying to guesstimate how much something is, I actually do a real conversion. Guess what, that 1/4 teaspoon REALLY does make a difference. 

  Second, I learned to be patient. I was always poking at whatever was in the oven, flipping things constantly on the grill or popping the lid off the pot. Now I have learned things need time, just like you can't rush a patient into taking their meds or giving you that urine sample you needed an hour ago, you can't rush food into being done. 

  I also learned that timing and time management in cooking is pretty much the same as in nursing. When I begin my night I sit down and look at what meds I have to give and when, I look at my timed lab draws and plan out when I'm going to do things and cluster my care so that I am in the room disturbing that patient as little as possible. Cooking requires the same skill, what can be in the oven at the same time, when to start cooking what so that everything is ready at the same time. Now that I have mastered this you rarely see overcooked meat being served with under cooked sides anymore. My husband has never said anything, but I notice that he's asking for seconds now.

This one should go without saying or surprise, but it still caught me off guard. I have never really had a love for kids, as can be seen by my lack of them, but I was also never really good at entertaining them or controlling them. Perhaps this was due to a lack of interest. 

  Working an ED will teach you that the best way to keep a kids parent from bugging you is to keep their kids from bugging them. Because of this I always keep a small box in my locker full of crayons, cheap coloring books and stickers, and yes it's all bought by me with my own cash that's how much I value my sanity. Now when I head out to spend time with friend and kids I always toss one of the "sanity packs" into my purse, it's amazing how long  4 crayons and some stickers will keep a little one happy. My friends seem to think it's funny that the gal with no kids always is prepared for them.

  Oh yeah and I've learned kids aren't dumb, not even the little ones, so don't treat them like it. In the hospital they know exactly what is coming, so I never lie and tell them it won't hurt when it will and I never try the ambush tactics some nurses think actually works. When I'm around kids that I am not treating I have learned to apply that principle too, I talk to them, guess what a couple questions directed at the kiddos over lunch generally leads to less screaming for attention, go figure. If the screaming does occur I have learned that a well controlled tone of voice goes WAY further than yelling, just like with the patients, honestly kids and patients aren't all that different in the end , they just want to be treated like people and included. Weird huh?


  I've always had plenty to say and never held back in delight or in displeasure, but nursing has taught me there is an art to doing it right. In the past I have been know to just go off and heaven help anyone in my way, now I've learned to do it better.

  Meaning what? For starters I usually take a moment to step away from the problem, take a deep breath and compose myself, just like I do when I want  to tell a patient what an unreasonable jerk they are being but instead explain with a sweet smile on my face that the reason I can't give them any food is because they are going to have surgery in the AM and you can have food in your tummy when that happens in case you throw up, aspirate and die. I use that moment to order my thoughts in a logical manner so that I sound like a reasonable person not a raving lunatic, astonishingly it gets you way further.

  I also learned to take the mail to the right address. I no longer complain to the poor sod at the cash register for the long wait, he/she is probably just as ticked off about having no help, but you betcha I will take it up with the manager. Just like I hate fielding complaints over things I have no control over, I bet anyone else hates it too.

  So yes I will give my instructors their dues and say, yes they were right. There is something about being a nurse that changes you, it gets into your blood and you will never really be the same person you were before you started. 

  What has nursing taught you?

Monday, August 13, 2012

Medical Scrubs Mall Review

  I don't usually shop on the internet but, when it comes to my scrubs I'm all for it. There are not many places in my town that are close to me and let's face it shopping for medical uniforms is not a girls idea of a ton of fun, so I shop online from the comfort of home and let the scrubs come to me.

  Recently I was introduced to Medical Scrubs Mall, they have a great selection of scrubs at good prices. Importantly for me they have a huge variety of solid colored scrubs that can be easily searched, since I need to find scrubs in navy blue only. I love the fact that every set of scrubs on the site is displayed with the colors it is available in under the picture so I know instantly if I should bother taking a closer look. You can even click the color box and view the item of your choice in the color you are looking for so their are no surprises. If you are one of the lucky nurses who gets to wear prints these folks have a huge selection of the prettiest prints, I envy you ladies!

 I found this super cute warm up jacket on their site that I just have to have. I love the contrast detail, it fits into the work uniform without being blah. I need a ton of these jackets to stay warm, for some reason they keep our hospital about the same temp as an ice box!

  Speaking of keeping warm I also found this great long sleeve T-shirt to wear under my scrubs while I was looking around. I love layering pieces like these because they also keep your arms covered and protected from who knows what. I love the color and the fact that it's 100% cotton, which means it will breath. 

  So if you are like me and hate spending time in cramped, overflowing scrub stores and would rather be at home than out shopping for your uniforms I'd check these folks out.

Disclaimer: This post is sponsored by Medical Scrubs Mall. While the opinions in the above post are mine I have received compensation for the above review.


  Sorry for the layoff folks but I think this nurse is starting to feel the burn. Lately I have wanted to do nothing more than sleep, more so than usual, and stare at the TV. My brain feels like it has turned to mush when it comes to anything other than work. Thankfully I finally wrangled more than two days off in a row, which if you work night shift equals one day of sleeping and one day off. 

This is what I feel like life has become for me in the last few weeks. This week I finally decided to make a stand and squeeze in some time for ME.  I took some time to catch up on all the things I haven't had time to do. I actually read the pile of magazines that had accumulated on my coffee table, found time to actually see other people, and finally get that hair cut I have been promising myself. Now I actually feel like a real person again.

  Take this as a bit of a warning, find the time to take care of yourself, whether you are a student or a working nurse. Our schedules are hectic, we try to cram as much as we can into our days to "take care of business", but neglect ourselves in the process. I know we all have other things going on like kids, other jobs and spouses, and being nurses we naturally give a lot of ourselves, we wouldn't be in this business if we didn't, but we have to learn to take time for ourselves.

   The hardest thing for me to learn was to say no, but I have been finding myself doing it more often lately, and I found out I feel better for it. Not that I have been neglecting real, important things, but that I have learned that there are all sorts of little things that get piled on my plate that I say yes to that eat away at what little time that I have. I would love to help everyone and say yes to every request but lately I have had to be totally honest with myself and ask do I really want to do this, do I really have the time, and can I really put the amount of time into it to do it right? If I can't say yes to all three questions then it's time to say no. 

  We all have to learn where are limits are, and no post about preventing burnout really is going to be helpful, it's all about testing your limits and being smart enough to know when to say stop. I'm just here to say I found my point, be smart and realize where yours is. 

Take care all! I'm going to go sit in the pool and enjoy this day off, if it's your day off enjoy it!

Sunday, August 5, 2012

Sunday Morning Funnies

  You know you're an ICU nurse when you 
secretly admit to having wanted to do this.

You know you're an ER nurse when you 
have done this!

Happy Sunday!