I hope that everyone enjoyed and celebrated during the recognition days and weeks of the first half of 2012 (see Celebrate Nursing 2013: Part 1). On to Part 2…

Vascular Nursing Week June 9-15

National Time Out Day June 12

36th Annual National Nursing Assistants Week June 13-20

Healthcare Risk Management Week June 17-21

National Nurses in Staff Development Week July 2-9

National Pediatric Hematology/Oncology Nurses Day September 8

Nephrology Nurses Week September 8-14

National Clinical Nurse Specialist Week September 1-7 (2012 date – will update when available!)

Neonatal Nurses Day September 15

Gerontological Nursing Week September 29-October 5

National Midwifery Week October 6-12

Emergency Nurses Week October 6-12 (Emergency Nurses Day is October 9)

National Pediatric Nursing Week October 7-13

National Case Management Week October 13-19

National Hospice/Palliative Care Month November

Medical-Surgical Nurses Week November 1-7

Urology Nurses and Associates Week November 1-7

Emerging Nurse Leaders Week November 3-9

Perioperative Nurses Week November 11-17

National Nurse Practitioner Week November 11-17 (2012 date – will update when available!)

Forensic Nurses Week November 12-16 (2012 date – will update when available!)

In the hustle and bustle of everday life, obtaining the correct number of contact hours for licensure and recertification can get pushed to the bottom of the 'to-do' list. If you’re anything like me, when license renewal time comes around, it’s a bit of a scramble to get organized and count up the number of hours I’ve accumulated since my last renewal and figure out how and when I’ll finish up in time. 

Since launching NursingCenter’s new CE Connection, we’ve had the opportunity to bundle topical collections of continuing education articles and made them available at a discounted price.  So far we’ve put together a collection around Understanding BRCA and Cancer Risk (9.9 contact hours for $24.99) and one on Caring For Veterans Suffering from War-Related Injuries (11.4 contact hours for $28.99). I’m working on some more of these collections, but would like to best meet your needs! So, please let me know – what types of collections would be of interest to you? Is there a certain clinical topic or patient population that you’d like me to address?  

Also, are there any special requirements for your state or your certification? For example, New Jersey now requires at least one hour of continuing education related to organ and tissue donation and recovery. We will do our best to keep you informed based on your profile selections on Lippincott's NursingCenter.com. If you’re not yet a member, you can certainly join now – it’s free!

We want to help you keep up with your requirements – please let us know your needs by leaving a comment or you can always email me at clinicaleditor@nursingcenter.com. 

Thanks!

As Nurses Week is winding down, I am honored to share this excerpt from “The American Nurse.” Created by Carolyn Jones, this book explores the unique lives of nurses using photographs and personal stories. 

This infographic was shared with us by Erica Moss, who is the community manager for the online nursing programs at Georgetown University School of Nursing & Health Studies.

Attending any conferences this spring? Here’s a list of tips and timesavers to help you make the most of your time! 

1. Make a schedule. Plan which sessions you’ll attend and create your itinerary! Use the most convenient form that works for you – paper and pencil list or electronic device. Some conferences even have a smartphone app to help you do this. Check the attendee program or ask at the registration desk for details.

2. Pack comfortable shoes. Conference centers can be large, especially if it’s a big event with a large number of attendees. Also, remember that the walk through airports, train stations, and other public transportation centers can be long as well.

3. Do your homework. If you would like to speak with a presenter or are interested in connecting with a particular exhibitor, prepare your questions ahead of time. Sometimes the lines can be long and there may be limited time between sessions. Make sure you make the most of your time and convey your message clearly and succinctly.

4. Bring a notebook. Make notes on your computer, mobile device, or use pen and paper. Things you are learning and hearing will be fresh and exciting at the time, but when you return to your “real world,” you might not remember everything like you thought you would.

5. Keep some snacks handy. Not all airlines provide snacks, or if they do, there may be a charge for them. Also, if you are attending back-to-back sessions without much of a break, having a snack or two on-hand can help ease your hunger and keep you alert.

6. Consider packing an extra bag. You may accumulate quite a bit of ‘extras’ during the conference. From handouts and journals to goodies from the exhibit hall and souvenirs, it might make packing for your return a little easier. Be aware of airline restrictions and fees however! You could even consider using a larger bag than you need so you’ll have extra room for your return trip.

Enjoy your conference! Let me know which you’ve attended or are planning to attend, and what exciting and innovative things you learn. Also, please share your own tips too!

As I write this, I’m on my return flight from Nursing2013 Symposium in Las Vegas, Nevada. With each conference I attend, a highlight for me is developing new relationships and strengthening older ones with nursing colleagues from around the country and world. As nurses, we have an incredible amount of knowledge and experiences to share and getting away from our workplaces and joining together to talk and learn is exhilarating! By the nature of my work, so many of my relationships are “virtual” ones – communication via email, text, and social media is more the norm for me than face-to-face conversations, so it thrills me to connect in person with nurses that I’ve only “met” online.

I have quite a bit to share from this conference, but let me start with quotes that inspired & educated me during this event!

“Many times, a patient’s history leads to a diagnosis; the physical examination supports that diagnosis.”
Anne Dabrow Woods, MSN, RN, CRNP
Physical Assessment Skills for Adult Patients

“The most accurate way to take a blood pressure is by using the bell of the stethoscope.”
Anne Dabrow Woods, MSN, RN, CRNP
Physical Assessment Skills for Adult Patients

“It doesn’t take a title to be a leader.”
Jeff Doucette, MS, RN, CEN, FACHE, NEA-BC
Leading From Where You Are: Creating a Culture That Inspires

“Staff nurses are front-line leaders and often hold the key to resolving turnover drivers.”
Jeff Doucette, MS, RN, CEN, FACHE, NEA-BC
Leading From Where You Are: Creating a Culture That Inspires

“The best leaders are personal leaders.”
Charles Denham, MD
A Lifesaver for Lifesavers: How to Survive the Rough Seas of Patient Safety and Value-Based Purchasing Demands

“Human factors that contribute to the complexities of patient handoffs include too few nurses, fatigue, rushed report, memory, nursing turnover, emotion, and information/sensory overload.”
JoAnne Phillips, MSN, RN, CCRN, CCNS, CPPS
Effective Handoff Communication: A Key to Patient Safety

“Every time lactate increases by 2, the risk of death [from sepsis] increases by 20%.”
Julie Miller, RN, BSN, CCRN
Sepsis: Nurses Implementing the Latest Guidelines

“The mortality for sepsis equals that of an acute MI in 1960.”
Julie Miller, RN, BSN, CCRN
Sepsis: Nurses Implementing the Latest Guidelines

“For every organ system that fails, mortality [from sepsis] increases by 22%.”
Julie Miller, RN, BSN, CCRN
Sepsis: Nurses Implementing the Latest Guidelines

“Falls are an adverse drug reaction.”
Anne Dabrow Woods, MSN, RN, CRNP
Recognizing and Treating Adverse Drug Reactions

“Angioedema from ACE inhibitors is not dose dependent.”
Anne Dabrow Woods, MSN, RN, CRNP
Recognizing and Treating Adverse Drug Reactions

“Start with what you know best, maybe a case study, and start writing.”
Denise Drummond Hayes, MSN, RN, CRNP
Bylines and Deadlines: Writing for Professional Publication

“Our work is based on science and evidence, but we are best known for our caring side.”
Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC
Finding Your Nursing Voice

“The person with a strong nursing voice is an expert problem solver who is more proactive than reactive.”
Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC
Finding Your Nursing Voice

As many of the sessions were happening concurrently, I know there is so much that I missed and I look forward to listening to several of the presentations when they are available online. For those of you who attended this conference, please share what you learned and what inspired you too! 

Also, you can view some photos from the conference on our Facebook page!

How do you greet a patient?
With a hello? A smile? An introduction?
Do you share your role? The plan for the day?
Do you make eye contact?
How do you address him or her? Mr., Mrs., or Ms.? By first name?

Then what do you do?
Do you wash your hands?
Do you write or type while talking?
Do you use therapeutic touch?
Those communication skills you learned in nursing school?

How do you include the family?
Do you share information?
Did you ask the patient if it's okay to do so?
Do you consider everyone's feelings?
Do you welcome visitors?

How about your assessment?
Do you go head-to-toe?
What questions do you ask?
Do you teach as you go?

How and when do you document?
Electronic health record? Paper chart?
Do you use a checklist?
As you go? Or toward the end of your shift?

How about medications?
Do you know the indications and recommended dosing?
How about interactions and adverse reactions?
Do you ask a colleague to check calculations?

How do you handle other interventions and procedures?
Do you provide privacy?
Do you explain what you are doing?
Do you ask if the patient has questions?
Are you able to answer?

Time to go home?
Did you get a break?
Did you eat? Use the restroom?
Are you ready to leave?

How do you say good-bye?

How many times has a patient said “I feel funny” or “I don’t feel right” and then proceeded to code shortly thereafter? That happened to me twice.

How many times have you felt pulled in different directions – between call lights, alarms ringing, medications to be administered, dressings to be changed, patient education to be provided, etc.? For me the answer is TMTC (too many to count!)

How many times has a patient deteriorated quickly or coded without any warning signs? I’d say several.

I wonder if during any of those times a patient was trying to reach out to me to say “I feel funny” or “I don’t feel right” and the opportunity to intervene passed without my knowledge because I was busy with other tasks.

Just thinking…

I wish that we had enough time during our day to just pause and listen. Wouldn’t that be nice?

Happy New Year everyone! Here’s the list of nursing recognition days and months for the beginning of 2013*. I found some new additions for this year’s list – Critical Care Transport Nurses Day and National Nursing Home Week. Please let me know if you know of others.

Be sure to celebrate your hard work and the hard work of your colleagues – Enjoy!

*I will add/update links as they become available.

National Nurse Anesthetists Week
January 20-26, 2013

National IV Nurse Day
January 25, 2013

PeriAnesthesia Nurse Awareness Week
February 4-10, 2013

Critical Care Transport Nurses Day
February 18, 2013

GI Nurses and Associates Day
March 27, 2013

Certified Nurses Day
March 19, 2013

National Radiology Nurses Day
April 12, 2013

National Critical Care Awareness and Recognition Month
May 2013

Oncology Nursing Month
May 2013

National Nurses Week
May 6-12, 2013 (National Nurses Day is May 6)

National Student Nurses Day
May 8, 2013

National School Nurse Day
May 8, 2013

International Nurses Day
May 12, 2013

National Nursing Home Week
May 13-19, 2013

Neuroscience Nurses Week
May 19-25, 2013

I have been trying to limit my watching of the Newtown, Connecticut events on television. I feel guilty about it, as those directly affected by the horrible massacre that occurred December 14th must face the tragedy every minute of every day. Like you, I am experiencing all sorts of feelings of sadness and anxiety and my thoughts and prayers are with the victims, their families, and the first responders.

I have not limited my reading though. I feel that by reading the stories shared by family members, I am getting to know the victims and in some small way, I am honoring them. I am reading the stories shared by the survivors and feeling that in some small way, by doing so I am helping them process the events by “listening.” I am reading the thoughts and feelings of how others are processing what happened, hoping to contribute to the discussion and let our voices be heard so that changes can be made to make our nation a stronger and safer place for ourselves and our children. 

Now I turn to the feelings of “How can I help?” and “What can I do?” I encourage you to see posts from our colleagues at AJN’s Off The Charts and Nursetopia for lists of resources and ways to help. Also, the American Nurses Association has assembled a list of more than 30 nursing organizations joining forces to call for change. 

“The nation’s nurses call on President Obama, Congress, and policymakers at the state and local level to take swift action to address factors that together will help prevent more senseless acts of violence. We call on policymakers to: 

• Restore access to mental health services for individuals and families 

• Increase students’ access to nurses and mental health professionals from the elementary school level through college 

• Ban assault weapons and enact other meaningful gun control reforms to protect society”

Nurses – we are the largest single group of health care professionals. We see the devastation caused by weapons and violence. We care for patients with mental illness and know there is need for improved services and access to treatment. It is time to take action.

I’ve seen a lot of patients die. And by a lot, I mean too many to count. Some deaths I remember clearly, perhaps because the patient was alone or had a large number of family and friends at the bedside, perhaps because he or she was close to my age, or perhaps because of religious traditions that took place during or after the death. It’s odd then, that when I think back to last words of patients before they died, I am at a loss. 

It could be because many of our patients followed a similar pattern prior to their death. Many were on mechanical ventilation which was withdrawn after many days, weeks, or months of progresses and setbacks. Most were unresponsive, either due to sedation or their disease process. They may have spoken their last words in my presence, but at the time I may not have realized that they were the last words they would ever speak. 

I do remember the last words of one patient in our unit. She was my grandmother. After a fall with a resultant hip fracture, she was transferred to us several weeks after surgical repair of her hip. Her oxygen requirements were increasing and she was becoming more and more agitated. In our unit she was treated for aspiration pneumonia, given anxiolytics, and supported with more and more supplemental oxygen each day.

We, her family, knew her wishes – she didn’t want to be intubated – and we respected that. I was working night shift, not as her nurse, but would stay much of the morning to help with her am care and to be there for rounds. On one particular morning, she was coughing and vomited. She had a hard time catching her breath. I called out for her nurse to suction her, when my grandmother grabbed my hand and said “No more.” We spoke of what that meant; it was a pretty intense conversation for a young nurse to have with her own grandmother. Then I called the rest of the family to explain our conversation and ask that they come to be with us. 

Everyone arrived throughout the day and we did what we could to keep her comfortable. We all spent time holding her hand and chatting with her when she was able. At one point, my grandmother asked for a grape soda. I found one for her and as she sipped it through a straw, she said to me “Lisa, I won’t be at your wedding.” “I know,” I said, “Grandmom, but you will always be with me.” Her response was “Yes… and grandpop knows what to give you.”

And those were her last words to me. I knew that she was referring to a wedding gift, and I laugh now when I think about it, because that was typical of my grandmother. She was an incredibly generous woman…always fighting over the check at dinner and pushing to pay at any cash register. These final words make me smile and think of who she was, not laying on that hospital bed, but as my grandmother.

What made me think of this was a recent book I just completed. In Looking for Alaska by John Green, the main character has a fascination with last words. He reads countless biographies and has memorized last words, even making it his mission to discover the “Great Perhaps” mentioned in the last words of François Rabelais. It was a good read, definitely thought-provoking, and I thank my niece for recommending it to me.

As nurses, some of us work with dying patients on a daily basis, while others, only rarely or sometimes. Regardless of your experience, do any last words stand out in your memory?