We’re nurses…we notice things

There is a tree in our front yard that is dying. It’s a great big maple tree that used to be beautiful and provide shade for our house. Now it is without leaves on one side, and the bark is dark and peeling off revealing white, moldy-looking ‘insides.’ So we called an arborist in the hopes of treating and saving this special tree. After assessing the problem tree and giving us his diagnosis, the tree expert commented “I couldn’t help but notice another tree by your front door. It seems to have __________ (insert long, Latin name of tree disease here!)” Hmmmm… does this happen with every occupation?

From the time I started learning about anatomy, physiology, pathophysiology, pharmacology, and all other things nursing and healthcare related, I’ve been much more observant of peoples’ health status. I always notice “good veins.” I can spot someone with hyperthyroidism a mile away. I worry when I see someone with clubbing and wonder what their oxygen saturation is. And if someone tells me their prescriber put them on furosemide, I immediately think about the importance of following their potassium levels.

Have you noticed similar changes in yourself since you’ve become a nurse? Please share - I’d love to hear about them!

Posted: 8/16/2010 12:59:29 PM by Lisa Bonsall, MSN, RN, CRNP | with 3 comments

Categories: Inspiration

A Memorable Mentor

My most memorable mentor has to be my first preceptor after I graduated from nursing school. As a new nurse in the medical intensive care unit, I was pretty nervous and overwhelmed. I had worked in the unit for about a year and a half as a nursing assistant, but I knew how different my role would be as a new RN. 

This nurse was literally always teaching. And not just me… anyone who she came in contact with learned from her. She was an expert and I honestly can’t remember a time when she didn’t know something. She sought out new experiences for me and encouraged me to be on the lookout for new experiences throughout my career.
Amazingly, she was able to see patient care from my standpoint as a novice. She started with the basics and was able to help me build upon my knowledge and skills in a way that made sense to me. Later, as I became more confident and comfortable, she would begin her questions to me with “What would you do…” or “How would you know…”

One important quality that stood out about this nurse was her respect for everyone - patients, family members, nurse colleagues, and other members of the healthcare team. She was a good listener, had amazing clinical skills, and a knowledge base that boggled my mind!

This nurse was more than my preceptor, she was a mentor and friend to me. I feel so fortunate to have been mentored by such a wonderful role model. Who is your most memorable mentor?
Posted: 8/14/2010 10:21:10 AM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

More to think about at the end of life

Providing end-of-life care can be one of the most challenging responsibilities as a nurse, yet can also be one of the most fulfilling. When a patient’s wishes are respected and dying with dignity is a priority, death can be a peaceful and positive experience for the patient, his family, and the staff caring for him.

Oftentimes, our focus during end-of-life care is primarily on pain management and relieving or preventing labored breathing. Research published last month in the Archives of Internal Medicine calls attention to other factors that need to be addressed to improve care at the end of life. These include communication deficits, the importance of dyspnea assessments, implantable cardioverter/defibrillator deactivation, and bowel regimens.

In my opinion, the importance of communication at the end of life cannot be stressed enough. This includes communication among staff, among the patient and his family members, and between staff and the patient and his family. How many times have you encountered family members who didn’t agree with the wishes of a loved one as stated in his living will or who didn’t understand that an illness was terminal? How about physicians, nurses, and other professionals who were reluctant to address end-of-life issues?

It is important for all decision-makers and caregivers to understand and agree on a plan in order to ensure a positive experience at the end of life. For this to happen, communication is key. Take some time to read the following articles. You’ll find some great information to help educate patients, families, yourself, and your colleagues about end-of-life issues and care.

Posted: 7/11/2010 2:07:55 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

Do you think you were destined to be a nurse

Last spring, when we entered this new world of social media, it was quite a new experience for most of us at NursingCenter.com. We did our research, enlisted some help, and then got our feet wet with a Facebook page and Twitter account.

Back in August of 2009, we posted one of our first polls on Facebook. None of our polls really ever got much of a response; perhaps our topics weren't that enticing or it was just easier to comment on a wall post than to actually vote in a poll. Somehow (I'll admit that this was not my intention initially!) one of our polls became a box on our ""wall"" page. This poll caught my attention recently as I was perusing the list of our latest fans. What a surprise when I saw the amount of responses that had accumulated over the past months.

We've had 286 responses to ""Do you think you were destined to be a nurse?"" After getting 10 to 20 responses on several other polls, I found 286 to be impressive. But what I find even more impressive is that 83% of the respondents said ""Absolutely!"", while only 3% voted for ""Don't think so."" Fourteen percent replied ""Maybe - never really thought about it.""

So, now I ask you, our blog readers, do you think you were destined to be a nurse?

Posted: 6/1/2010 1:03:10 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

Is nursing really for me?

During my first year of nursing school, my grandfather underwent quadruple bypass surgery. My father and grandmother were very proud to introduce me to the nurses caring for him as “his granddaughter, a future nurse.” I have to admit that I felt quite a sense of pride with that introduction as well. Then we walked into his room in the surgical ICU…

My clinical experience had been minimal thus far, really just “communicating” with actual patients a handful of times.  Did practicing reflection, active listening, and restating prepare me for what I was about to see? I’m guessing not, since after I took one look at my sweet grandfather with all his post-op CABG attachments, I promptly hit the floor. That’s right, I fainted.

Uh-oh….was I really cut out to be a nurse? I wasn’t so sure anymore. My grandfather recovered without incident and fortunately, once he was out of ICU, I was able to visit him without any further incidents myself. I didn’t let this alter my career path and I continued on with my nursing education.

The following year, my father had surgery for skin cancer. The procedure involved attaching a flap of skin from his forehead (which remained attached there) to his nose, where the cancer had been removed. This flap would remain for several weeks until it began healing in its new location. I was a sophomore in school now and had a little more clinical experience under my belt, albeit not much. My parents planned his surgery during my winter break so I could be home and help out with his wound care. Big mistake - yet again, I was not very helpful. I could barely look at my father, even with his dressings in place, without getting light-headed.

Well, believe it or not, I did finish nursing school and found my niche in critical care nursing. When I think back to the types of patients I cared for in the medical intensive care unit, I’m amazed that I never once lost consciousness! How could I have doubted my decision to become a nurse? I thrived on caring for the sickest patients, using highly-technological interventions, and even dealing with the ugliest of wounds. Even post-mortem care was not an issue for me - I had a respect for that privilege that is indescribable.

So what is the message here? Expect to have doubts, but don’t let those doubts throw you off track. Talk to someone about your concerns. Remember why you wanted to become a nurse and what drove that decision initially. Look to your peers, clinical faculty, and other nurses for support and guidance. Chances are that you will meet at least one person who has had similar feelings and experiences. Be open to advice and encouragement, and be confident that in the end, you will follow the path that is right for you.

Posted: 5/14/2010 1:10:30 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

I've got your back....

What do you really want for Nurses Week?  Is it the pen, the water bottle, the shirt, or food?  Do these things really make you feel appreciated?  While I won't deny I am happy to receive these token gifts; what I really want is for my colleagues to say thank you for having their back.  The last shift I worked was especially busy.  Most of the patients were on ventilators and vasopressors.  Each room seemed to have a more critically ill patient than the last room.  The Emergency Department had several critically ill patients to transfer up to us and the medical/surgical units were backed up with patients, so they couldn't take any transfers.  This scenario is typical for anyone that works in acute care today. 

What made the day a good day, yes that's right I said a ""good day""; was the fact that we all worked together.  When one nurse had a patient in crisis, the other nurses were right there to pick up her other patients or help her handle the crisis.  The day ran like a ""well oiled machine"" because we had each other's backs and we took the time to say ""thank you"" to each other.  Never was the situation out of control, never did chaos reign supreme. 

It doesn't matter whether you're an advanced practice nurse, an RN or an LPN; we're all colleagues working together for one purpose.  So to all my colleagues out there; ""Happy Nurses Week and thank you. I''ve got your back because I know you have mine.

By Anne Dabrow Woods, MSN, RN, CRNP, ANP-BC

Posted: 5/5/2010 8:46:35 AM by Cara Deming | with 1 comments

Categories: Inspiration

Improving World Health Starts at Home

If you think about the issues affecting world health today, it's easy to be overwhelmed. Just thinking about the challenges we're facing in the United States is overwhelming enough; so you can imagine the task the U.N. faced when it decided to address the health and welfare issues of the globe. 

The Millennium Development Goals developed by the U.N. include: end poverty and hunger; universal primary education for all persons; promote gender equality and empower women; reduce child mortality; improve maternal health; combat HIV/AIDS, malaria, and other major diseases; ensure environmental sustainability by providing safe drinking water and basic sanitation; and develop a global partnership that addresses special needs of developing countries, provides access to affordable essential drugs, and access to new information and communication technologies.

As nurses we are in a unique position to impact the health and welfare of people in our own back yard and around the globe. Several thought leaders from Sigma Theta Tau International, the Nightingale Initiative for Global Health, and the Florence Nightingale Museum believed in this ideal and created the 2010 International Year of the Nurse initiative. IY Nurse 2010 was developed to recognize the contributions of nurses globally and to engage nurses in the promotion of world health.

I challenge each of you to read about the U.N. MDG goals (http://un.org/millenniumgoals), and the efforts of IY Nurse 2010 (http://www.2010IYNurse.net ).  Look for opportunities where you work, in your neighborhood, and in your community where you can partner with other nurses and healthcare providers to affect change.  I look forward to hearing your ideas on how we can make a difference.

Posted: 1/19/2010 1:13:34 PM by Lisa Bonsall, MSN, RN, CRNP | with 2 comments

Categories: Inspiration

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