Archive for the ‘Social media’ Category

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Nursing Perspective: Why I Work in Corrections

January 23, 2015

By Megen Duffy, BA, BSN, RN. Her blog is Not Nurse Ratched.

Michael Coghlan/Flickr

Michael Coghlan/Flickr

When I go to work, I go through a metal detector (did you know Danskos contain metal?), and all my belongings are scanned or gone through. I check out keys and a radio, and then I go through a series of sally ports to get to the medical area. I count every needle and pair of scissors I use. I never see patients without an armed guard nearby, and a good portion of my patients are cuffed and shackled. I’m on camera from the second I get out of my car.

Welcome to prison, nursing style!

“Why?” people ask me. “Couldn’t you get another job? Aren’t you scared? Didn’t you like the ER?” I worked in critical care/emergency nursing for a long time, and yes, I did like it. I brought those skills with me to corrections, where they are a lock-and-key fit. A surprising number of corrections nurses are ex-ER nurses. The same personality types work well in both settings.

Corrections nursing involves phenomenal nursing autonomy and uses many of the skills I honed in the ER:

  • quick triage
  • multitasking
  • sorting out who is lying from who is sick
  • knowing which assessments are the most important for each situation

The atmosphere tends to be quirky to chaotic and requires imagination, flexibility, and an ability to string together solutions to problems that no one has ever seen before. Particularly in jails, you never know what is going to come through the door. A jail booking area is exactly like ER triage.

I like that; I like having a job where strange things are bound to happen. I like seeing things that most people never see. I like knowing that things could get hairy at any time and that I have to be on my game all the time. Read the rest of this entry ?

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A Brief Meditation on Love, Loss, and Nursing

January 14, 2015

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

Manicure, by Julianna Paradisi, 2014

Manicure, by Julianna Paradisi, 2014

As a child, I remember being afraid to fall in love, because I didn’t want to experience the pain of losing people I loved when they died. I don’t know why I thought about this; I only know that I did.

Becoming a nurse has done absolutely nothing to alleviate this fear, but life experience has, to some degree.

Nursing is hard not only because we are there for the dying, but also because we are there for the illnesses and deaths of our own, the people we love, too. Making a living by caring for the sick and dying does not exempt us from personal loss. We grieve and mourn like everyone else.

Recently, I sat in a chair in an emergency department, noticing the sparkly red polish of a woman’s holiday manicure as she rolled past on a gurney. Clearly, she hadn’t anticipated an ER visit as part of her holiday celebrations either. On another gurney, next to my chair, lay my husband, getting an EKG, labs, and IV fluids. The prayer, “Please, don’t let it be a heart attack or a brain tumor,” wove silently through my thoughts.

We were lucky. There was no heart disease, no brain tumor. It was viral, just a touch of the flu. Two liters of IV normal saline did the trick.

“Thank you.”

I wish everything could be cured with a couple of liters of normal saline. There are nurses reading this post who recently grieved for loved ones absent from their places around the holiday meal table. No one mentions that all love stories eventually end. The most enduring conclude at death, and there’s the burn. Nurses know there’s no such thing as love without loss. Read the rest of this entry ?

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Nurses at Center Stage: AJN’s Top 10 Blog Posts of 2014

December 12, 2014

By Jacob Molyneux, AJN senior editor/blog editor

Scanning electron micrograph of filamentous Ebola virus particles budding from an infected VERO E6 cell (35,000x magnification). Credit: NIAID

Filamentous Ebola virus particles budding from an infected VERO E6 cell (35,000x magnification). Credit: NIAID

It’s unsurprising that some of our top blog posts this past year were about Ebola virus disease. But it’s worth noting that our clinical editor Betsy Todd, who is also an epidemiologist, cut through the misinformation and noise about Ebola very early on—at a time when many thoughtful people still seemed ill informed about the illness and its likely spread in the U.S.

Ebola is scary in itself, but fear was also spread by media coverage, some politicians, and, for a while, a tone-deaf CDC too reliant on absolutes in its attempts to reassure the public.

While the most dire predictions have not come true here in the U.S., it’s also true that a lot of work has gone into keeping Ebola from getting a foothold. A lot of people in health care have put themselves at risk to make this happen, doing so at first in an atmosphere of radical uncertainty about possible modes of transmission (uncertainty stoked in part by successive explanations offered as to how the nurses treating Thomas Eric Duncan at a Dallas hospital might have become infected).

And while, relative to the situation in Africa, a lot of knowledge and resources were readily available to support nurses and physicians who treated Ebola patients, the crisis has focused much-needed attention on the quality of the personal protective equipment (PPE) hospitals have been providing to health care workers.

Meanwhile, the suffering continues in Sierra Leone and other countries. Time magazine this week made the Ebola fighters here and overseas its collective Person of the Year for 2014. (See our recent post by Debbie Wilson, a Massachusetts nurse who worked in an Ebola treatment center in Liberia this fall. She will be visiting our offices next week for lunch with the staff.) Read the rest of this entry ?

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Unbalanced: The Art of Changing Nursing Roles

October 1, 2014
Bull and Monkey/ graphite, charcoal, acrylic on vellum/by julianna paradisi

Bull and Monkey/graphite, charcoal, acrylic on vellum/by julianna paradisi

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

The culture shock experienced by new nurses making the transition from student to professional is well documented. Less well documented is the culture shock seasoned nurses face when changing jobs. Not all nurses are the same. Neither are all nursing jobs.

Working in an unfamiliar setting means being the new guy. You may have been in the top 10 of your nursing class for grades and clinical excellence. Or you may have held a position of leadership in your previous unit. In your new job, you are unknown and unproven.

For nurses changing jobs from high-acuity areas—ICU or bone marrow transplant, say—to an ambulatory clinic, the stress is twofold.

First, there’s a period of grieving the loss of hard-won skills and certifications that are not applicable in the new role.

Then there’s the shock that your skills and experiences did not prepare you for the outpatient setting. Often, the first realization is that high-acuity patients have central lines, so a nurse migrating from such a practice area may not have strong peripheral IV skills.

By contrast, placing peripheral IV’s is something outpatient infusion nurses do all day long; IV placement skills are learned over time through practice. The nurse experienced in high-acuity patient care is suddenly a beginner, often needing the help of coworkers to insert IV’s in patients. The inability to consistently start a peripheral IV is frustrating for the nurse and for coworkers, not to mention the patient.

I’ve been thinking a lot about how it feels to be new at a job, because of the changes at mine (see earlier post, “The ACA and Me: A Dispatch from the Trenches”). Although my job is basically the same job that it was, the oncology piece has greatly expanded, and I’ve worked hard to become familiar with numerous chemotherapy regimens. Read the rest of this entry ?

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If You Want to Write, Do It (and Skip the ‘Weaseling Qualifiers’)

September 26, 2014
Photo by mezone, via Flickr.

Photo by mezone, via Flickr.

Are you one of those people—nurse or otherwise—who daydreams about writing (a personal essay about a formative experience, an article about a quality improvement project you took part in, a blog post about some aspect of nursing) but can’t seem to find the proper way to get started?

Since the weekend is coming and the October issue of AJN is now live on our Web site, it seems a good time to draw attention to “On Writing: Just Do It,” the editorial by Shawn Kennedy, AJN‘s editor-in-chief. Kennedy points out the one idea common to most writing advice: you have to start somewhere. You have to do it, and learn from doing it, and then keep doing it. Or, as she puts it:

One key to becoming a good writer—or a good anything—is persistence.

But the editorial also gives a range of other excellent tips from Kennedy and several experts in the field, and quotes writing advice found in AJN issues through the decades. My favorite bit is from a 1977 editorial by former AJN editor Thelma Schorr:

“[the writer] will use the active voice and not shirk his [or her] responsibility by introducing a statement with such weaseling qualifiers as ‘It is considered that…’ or ‘It is generally believed that…’”

What a great word: “weaseling.” It’s about as far as you can get from the jargon that afflicts so much academic writing. So if you’ve got some free time this weekend, take 15 minutes and see what happens. Netflix will wait.—Jacob Molyneux, senior editor

 

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The Underlying Connection Is Nursing

September 22, 2014
Angel sculpture on grave marker

photo by author

Marcy Phipps, BSN, RN, CCRN, ATCN, TNCC, an ICU nurse who recently took up flight nursing, is an occasional contributor to this blog.

I recently experienced a series of events that seemed interconnected and orchestrated.

It started with my usual morning run. I was jogging out of my neighborhood, already sweating in the summer heat and absorbed—coincidentally—in an audio podcast about trauma care, when I came upon a man sprawled in the middle of a usually very busy thoroughfare. His motorcycle, badly damaged, was lying on its side next to a car with a crumpled door panel. The accident had clearly just occurred—traffic hadn’t yet backed up and no sirens could be heard heralding imminent assistance.

I had the weird sensation that I’d been running to the accident all along. I held his C-spine and monitored his neuro status while an off-duty paramedic managed the scene. Unexpectedly, a cardiologist I sometimes work with emerged from a nearby café and held his fingers to the man’s radial pulse, and then several more off-duty paramedics arrived.

It seemed fortuitous to me at the time—not the accident, of course, but the proximity of medical personnel who were so quickly available. And I had the impression that, despite not having worn a helmet, the motorcycle rider would be okay. He was talking to me, after all, and I didn’t see any obvious deformities or signs of severe injury.

About a week later, with the motorcyclist (and a shred of doubt) in the back of my mind, I glanced through the obituary section of the local paper. I should say that I almost never read the newspaper. When I do, I don’t look at the obituaries. And yet, on this rare occasion, I saw that not only had the motorcyclist succumbed to his injuries several days after his accident, but also that a patient with whom I’d developed a friendship several years ago had died, and that his memorial service was the following day. Read the rest of this entry ?

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Coincidental Violence Against a Nurse: More Prepared Than You Think?

August 25, 2014

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

The Myth of Closure/ oil stick and charcoal on paper 2014/ Julianna Paradisi

The Myth of Closure/ oil stick and charcoal on paper 2014/ Julianna Paradisi

Recently I was attacked by a stranger while running in the bright, mid-morning sunlight of summer through a populated urban setting.

My attacker did not know I am a nurse, so it’s only coincidental that it was violence against a nurse. However, I believe my nurse’s training contributed to choices I made in response.

How It Began: As I was running towards home through a busy recreational area along the river, a disheveled man on a bicycle turned a corner from the opposite direction and I swerved left to avoid collision. I thought nothing of it, and continued on.

First Contact: A few yards later, the same man rode closely up alongside of me so suddenly that I was startled when he angrily yelled something in gibberish. My nurse’s education and experience had schooled me not to react, not to make eye contact, and to get out of his personal space. At this point, the sidewalk forked. The stranger continued towards the left. I went right, on the greenway along the river. I kept running to put distance between us.

Second Contact: I felt him coming after me on his bicycle. I knew he was going to run me down. The nurse’s ability to critically think after a rapid assessment came to my aid. To the right was the river embankment lined with rocks. It wasn’t a long fall, but the loose rocks and the river held potential for further harm if he pursued. Instead, I chose to cross left, and then make my way up and through the landscaping of the riverfront condominiums. I didn’t succeed: he hit me from behind with his bike, yelling “Run faster!”

I knew it was important to stay on my feet, and throwing my weight backwards to stop the momentum, I did—grateful for an exercise class I’d started several weeks ago, strengthening my core. Read the rest of this entry ?

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