Things I’ve Learned: 90 Days of Nursing

Nurse w lampHard to believe I’ve been gainfully employed as a Registered Nurse for 90 days! Here are a few things I have learned:

Kinda cool: It’s a little thrilling to do some of those things that nursing students aren’t allowed to do for the first time: dispense certain medications, countersign high-risk meds, sign a nursing note with RN at the end of your name.

Happy Feet: Those shoes that got you through 8 hour shifts in nursing school may well be very inadequate for 12 hour shifts in real life. Keep in mind that a nurse very likely puts on 10,000 steps a day, minimum. She (ok, sometimes he) also spends a lot of time standing. Get good shoes. Also, consider upgrading your socks.

Time Keeps On Slippin’: Good time management skills are absolutely critical to doing all the things you need to do over the course of your shift.

The Little Things: There are a lot of nursing skills that require some serious fine motor skills. A nurse learns to do a lot of things one handed, with the other hand on the patient in some way. Oh, and some medications are just ridiculously hard to get out of their individually wrapped containers while wearing exam gloves.

A Spoonful of Sugar: A little old fashioned Dale Carnegie interaction with patients (and even coworkers) goes a long way at work.

On Uniforms: I kind of like wearing a uniform to work. I like being able to look around my facility and know exactly who does what.

That’s My Line!: Many people don’t understand the difference between a nurse and a CNA.

Things I Learned in Nursing School: Senior Edition

Nurse w lampThis is it folks, I have survived. Here are a few choice tidbits from the last semester

Wisdom from a Professor: “They don’t put trauma centers in nice neighborhoods.”

Political Power: One in every 10 women voters is a registered nurse (Source: Maurer, F., Smith, C.  (2013). Community/Public Health Nursing Practice, 5th Edition)

On Cars: When you drive a big yellow car, it’s totally reasonable to refer to it as Big Bird. Oh yeah, and one more thing I don’t like about GM vehicles: apparently some of them have their own phone numbers. Because we totally need cars to be phones in addition to connecting to our cell phones. Riiiiight.

On the PICU: PICU stands for Pediatric Intensive Care Unit. The kids there are very sick. This is not as sad a place as you might think. Or maybe I just have a ridiculously good attitude.

On Pediatrics: Much like Maternity, moms have a little advantage in this class.

Wisdom from another Professor, on How To Keep Your RN License: “Do your drinking at home, don’t take other people’s narcs [narcotics], and keep up with your CEUs [Continuing Education Units].”

On Yoga: Some classmates talked me into doing a brief yoga demonstration for a class project. People who don’t do yoga are impressed with what I can do. Imagine if they watched some of the other people in my yoga class….

On Chronic Illness: This semester, I had the opportunity to work with home health nurses. That is, nurses that actually keep people out of the hospital by visiting their homes. Now, think about your last doctor’s visit. You probably had to call some weeks in advance. Things ran late. You had paperwork, that was annoying because it was literally the same questions you answered last time you were there. Now, imagine that you or someone you love has a serious, debilitating chronic illness. Every day you have to deal with a system that requires multiple phone calls and properly filled out forms to get the simplest thing done. This system, which is supposed to “save money” by making sure services aren’t unnecessary or duplicated, costs time.

On Home Health Nursing: Florence Nightingale herself knew that nurses who go into the field need more training than their hospital-based colleagues. They don’t have a giant supply closet down the hall. They don’t have a charge nurse or any kind of help just a shout down the hall. They can’t count on a doctor coming by a little later. They have to look out for their own safety. Cars and cell phones have made the home health nurse’s life easier — you can have a trunk full of stuff and you can call for advice — but it’s still a hard job.

Things I Learned This Semester: Three Down

nurse washuI’ve just completed the third semester of nursing school, and I’m back with some more little things I’ve learned, in no particular order.

On Maternity: The nurses in the maternity ward think they have the best job in the whole hospital! And there’s something to their opinion: the overwhelming majority of their patients are fundamentally well. No other part of the hospital can claim that.

On Level of Consciousness: It is not normal to sleep through a blood sugar check.

We All Need the Duhpartment of Research: Yes, sometimes we do need scientific proof of what seems to be perfectly obvious. That’s because sometimes the perfectly obvious gets proven right, and sometimes it gets proven wrong.

On the Passage of Time: It’s just as well I didn’t study back in the 80s or 90s. I might be one of those nurses who say things like “We’ve always done it this way!”

Sometimes Questions are Opportunities: When you can’t easily find that somebody has answered your question, there is room for you to run a study and find the answers for others.

On the NICU: When I arrived in the Neonatal Intensive Care Unit, I was prepared for a depressing day. Instead, I found the tiniest humans showing fierce fighting spirit and overcoming the odds every day, with help from extremely caring nurses… and of course a lot of equipment. It turned out to be a highly satisfying experience where I felt like I made a difference.

Preemies Need Coffee!: Well, not really. But a bit of caffeine does help them breathe better.

Magnetic: There is such a thing as a Magnet Hospital. Such hospitals are supposed to “promote excellence in nursing and healthcare.” Sounds very buzzword compliant, doesn’t it? However, it turns out that such hospitals do have lower mortality rates and brings in more revenue than it costs to attain. That last bit is why you’re likely to see more of them in the future.

And that just about wraps it up for my third semester of nursing school. Stay tuned for the final edition at the end of June!


Deep in the Heart of Texas

Texas don’t need no steenking fact checking.

Ya know, when the Christian Science Monitor calls you out on your nonsense, you should probably pay attention!

In Closing: Taco Bell #1; The Princess who worked at Macy’s (and ran from the room when she met her future king!); and making abortions hard to get doesn’t prevent them.

If it bleeds, it leads…

And apparently, it can pay dividends: School shootings beget more school shootings. And unlike the days of Parkway South — which I bet you never heard of unless you knew somebody who was there — news coverage may be why. From the CNN article:

Researchers gathered records of school shootings and mass killings from several data sets and fit them into a mathematical “contagion model.” The spread they found was not dependent on location, leading researchers to believe that national media coverage of a mass shooting might play a role.

If you’re the kind of person who prefers to look at the research rather than the media coverage of it, good for you: here it is. Left to your imagination is whether other crimes might be subject to the “contagion model” described by the researchers. My guess is “probably.”

In Closing: dinosaur feathers; apparently he had a heart after all (no loss); stand and deliver all your ideologues.

Things I Learned This Semester: Summer Nursing School

Another semester has ended, and that means it’s time for another set of interesting things I learned.

On Google Maps: When you notice Google suggesting a “short” route to an off-campus event that cuts through an historically bad neighborhood, it’s a good idea to assume that some of your classmates aren’t aware of that.

On Psych: I learned something important about myself: I am not cut out to work on a psych ward. However, mental health nursing does teach important skills that are needed in any nursing practice. There will always be patients and/or family members experiencing anxiety, grief, depression, or using ineffective coping mechanisms such as denial.

On Suicide Watch: Someone will tell the nurse almost anything if they think it will get them out of the legal hold. Oh, and these guys do important work.

On Assigned Groups: This semester I had the opportunity to work with people I would not have chosen. It was a good experience. You don’t get to pick your co-workers either.

On Florence Nightingale: Your brain is the most important tool you can bring onto your shift. Don’t forget to not only do your job, but leave the next nurse with the information she needs to do hers (please forgive my pronouns; most Med-Surg* nurses are still women).

On Alert: It is mentally exhausting to be paying close attention for long periods of time, even if you are mostly observing.

On Social Media: we say so much we shouldn’t online, that the Department of Health and Human Services can use Twitter to track potential emerging outbreaks.

On Nursing Specialties: Most people know there are jobs for nurses on hospital floors (Med-Surg = Medical-Surgical) and doctors offices. There are also nurses who provide home health, nurses who try to figure out how to reduce infections and other complications, nurses who work with the IT guys to make more effective hospital computing systems, and of course nurses who work in specialized areas of the hospital such as the emergency department, the operating room, or the catheterization lab.

More another day!


Sex Ed in Clark County, Nevada

There is quite the local controversy surrounding exactly what students should be taught about their own bodies and sexuality in the 5th largest school district in the nation, Clark County School District. CCSD, to its credit, wants to teach more and make sure students get more accurate information. Students want that too. Parents, on the other hand, want to sharply limit what their kids learn, and they want to keep an “opt-in” mechanism so that parents actually have to sign a piece of paper saying it’s ok to teach kids about sex education.

Now here’s the thing. Well over 99.9% of school kids do in fact have either a vagina or a penis. Sure, I’ll allow for a small chance somebody doesn’t have one or the other. Those same parents who want to “control” how exactly how much their kids know about sex are not teaching them enough, and they aren’t starting early enough. These are the kind of parents who don’t bother to mention to a girl that she will get a period someday, waiting until the inevitable menarche panic. These are exactly the parents whose kids most desperately need sex ed.

Kids who don’t get enough information resort to asking friends who know little more than they do, as in that classic scene from your old Judy Blume book. They make mistakes because they don’t know any better. By contrast, kids who get sex ed wait longer to have sex, and they use contraception when they do — an unmistakable win-win reducing the chances of sexually transmitted diseases and pregnancy.

When I was young, most people had never heard of the internet. Now, thank [deity], there are places online where young people can get straight talk about their bodies and their sexuality.

Interested in more of my musings on this and related topics? Here’s Shelby Knox, contraceptives prevent abortions, and twisting the facts. Oh, and what do you call people who use the rhythm method of birth control? Parents!

In Closing: the return of the MERS controversy; Joe Biden’s TPP problem; wasn’t supposed to say that in public (but hey, in the summer of 2007 Hillary seemed inevitable too); internet hacks for students; gosh, that headline means something completely different until you get to the last two words; your elected representatives don’t care what your opinion is.

Back to School Repost Post

As our school and college students prepare to head back to school, I thought I’d go ahead and round up some things I’ve said over the years (mostly, with a couple new links too) for your entertainment:

Have a great school year.

In closing: I think this BlogHer post might have been talking about this one!

Voucher Detente

So, recently the State of Nevada passed a law allowing vouchers for parents to send their Special Snowflakes to private school on the public’s money. I have long been opposed to school vouchers for several reasons and if you’re curious, you can read about them here and here.

But it turns out that the Nevada law has a catch: to get the money, the child must be enrolled in a public or charter school for at least 100 days. Does anybody happen to remember how long a typical school year is? It averages 180 days.

So yeah, if you honestly give it an shot and the local public school isn’t working for your kid, the State of Nevada will help you out, but they’re not going to subsidize sending your Precious Darling to Las Vegas Day School or Bishop Gorman. You want the State’s money? You play by the State’s rules.

That is detente, Comrade.

In Closing: When a traffic citation can mean a death sentence, we all have a problem regardless of gender or color; Last Words; Waaah, Uber doesn’t like following rules!; hidden near Vegas; Votesmart; skewed; no surprise.