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.

Unfortunately, as healthcare providers, we must be prepared to intervene during emergencies that we would never imagine.  The bombings at the Boston Marathon have left me with a heavy heart, yet I am inspired by the stories of heroism that have resulted. My thoughts and prayers go out to all those impacted by this tragedy.

When a traumatic event occurs, I tend to immerse myself in information – not so much the media details surrounding the event, but in the human stories, especially about the “helpers” that I’ve been reading so much about over the last few days. We have several articles related to emergency preparedness that may give you some insight and confidence that you are the nurse that would be using your skills to care for the injured with expertise and compassion.

 Dealing with Disaster
Nursing Management, July 2007

 Disaster preparedness: Are you ready?
Men in Nursing, June 2007

 Emergency Department Response to Terrorism
Topics in Emergency Medicine, March 2005

Sending heartfelt wishes to those affected by the events of this week. Many thanks to the first responders for their swift action and to those who continue to care for the injured. 

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!

Two days ago we received 2 cards in the mail. They come every year at this time. They are never late and there is always a personal note included.

My sons are 12 years old today. These cards, which have come every year for the past 11 years, are not from their grandparents or aunts or uncles. They are not from their friends or my friends. These cards are from one of the nurses who cared for them in the Neonatal Intensive Care Unit (NICU) after they were born prematurely.

So I write this to recognize the continued feelings of gratitude and awe that I have for one special nurse. How can I thank her for caring for my children when I wasn’t able? How can I thank her for showing my boys love and compassion when I couldn’t be there? How can I thank her for helping us through our most difficult days, weeks, and months?

My boys are grateful to receive these cards each year and to be remembered on their birthday; however I’m not sure they grasp how much the cards are appreciated by me and my husband. This day of celebration for our kids still brings mixed emotions to us, feelings which are understood by this special NICU nurse who reaches out to us each year.

As a nurse, I have not had a continued relationship with any patient after discharge, although I can think of several that I wish I had. How about you?

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?

I’m drawn to articles that offer tips, top ten lists, mnemonics, and quick-reads to make our days and lives as nurses run smoother. That’s why I’m happy to share that we’ve just added a new article to our Recommended Reading list with not one, but two handy mnemonic devices! Plus, the topic is ECG interpretation and you may recall that one of my most memorable days as a nurse began with analysis of a Six-Second Strip. 

Please allow me to share one of these clever mnemonics with you here (you can click through to the article to learn the other – enjoy free online access while it’s on our recommended reading list). 

So, what are the H’s and T’s referred to in the title of this post? They are the reversible causes of cardiac arrest, which include:

* Hypovolemia

* Hypoxia

* Hydrogen ion (acidosis)

* Hypo- or hyperkalemia

* Hypothermia

* Tension pneumothorax

* Tamponade, cardiac

* Toxins

* Thrombosis, pulmonary

* Thrombosis, coronary

Do you have any similar mnemonic devices to share? Let’s help one another to remember all that is nursing and healthcare!

Reference:

Craig, K., (2013). Heart Beats: Rhythm self-quiz: Fast and deadly. Nursing2013 Critical Care, 8(1).

I’m a bit ashamed to be admitting this to a group of nurses, but I figure that if I shame myself enough maybe I won’t let this happen again. Ok, here it is…I didn’t get a flu shot. There, I said it. No reason, really, I just got busy and it kept getting pushed to the bottom of my to-do list. My husband got his at work, I took the kids for theirs, but mine – I just never got around to it. I am embarrassed and yes, more than a little nervous about getting sick. 

I’ve been reading a ton about this year’s influenza viruses "taking the U.S. by storm." I get emails from the CDC with the latest numbers and maps showing flu activity around the country. Our Nursing News page has links to updates and articles about this year’s virus. Our twitter timeline and facebook newsfeed also contain quite a bit of flu-related news, opinions, and personal stories these days. 

Not only am I “virtually” surrounded by the virus, but my kids come home from school each day with a report of who was absent, or more concerning, who was sick at school. My husband returns from his work as a respiratory therapist with a flu update from the hospital floors. And of course, I’m aware of every sniffle and sneeze around me when I’m out. 

My plan, which has been working well so far, consists of the usual recommended practices: frequent handwashing, not touching my face, getting enough rest and eating well, and doing my best to avoid those who are sick. However, while I’ve dodged illness thus far this flu season, I will surely be calling my nurse practitioner this week to schedule my vaccination! 

Any other advice? 

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.