Category Archives: Nursing

Donate to Keep Abortion Access Available in the West!

Around the same time as Margaret Sanger was going door to door through New York city, another young woman was faced with an unintended pregnancy. Already having two sons, there was no way her family could afford another mouth to feed. My great-great grandmother attempted a home abortion and died.

I love working for Planned Parenthood. Every day I am able to help young people access birth control safely and plan their fertility in a way that will allow them to be young people. I help mothers who were told breast feeding was enough. I help 45 year old women who thought they were “done with all that” (FYI – you’re not). I help trans folks and LGBTQIA folks and I am able to help so many people through my work at Planned Parenthood.

If you are getting this email, you’ve asked me for favors or money or some kind of help in the past, and I hope I was able to provide it. Right now, Planned Parenthood needs you. We need to be able to continue the valuable and lifesaving work we have been doing this entire time.

Please consider making even the smallest of donations. A couple dollars pays for a handful of condoms that we can pass out to 10 different patients. Planned Parenthood is an incredibly frugal organization. We quarter our sticky notes. We push ever single dollar as far as it will go. Please know that a dollar given to Planned Parenthood is a dollar that will help many people, many faces, faces that look like people you love.

Thanks for reading. Please consider donating, or if you cannot donate, please forward my campaign to that friend you have with money.

 

With my nurse’s stethoscope (inspired by @lilredrooster)

I have:

Heard a collapsed lung.

Informed the doc my patient had symptoms of a pulmonary embolism, NOT pneumonia.

Heard fluid and asked for a chest xray to confirm pneumonia

Heard new onset afib before the EKG could get in the room.

Heard that terrible sound a heart makes when there is an incredibly high potassium level

Listened to bruits and thrills.

Heard crackles, rales, wheezes.. and that awful silence.

Confirmed the nasogastric tube I just placed was in the correct spot.

Recognized anaphylaxis and called the code, enabling anesthesia to get there in time

Listened to the racing hearts of newborns

Listened to the last beat of a woman’s heart as I held her hand, like I promised I would.
Caught a BP too low for a machine to catch.

 

With my nurse’s stethoscope I have saved lives.

I have never borrowed a doctor’s stethoscope because if I ever didn’t have my own, another NURSE lent me theirs.

Change the narrative. Learn what nurses DO.

CIrcle of Love for Mama Josie

mamajosie

 

Josie Shapiro is one of the threads that holds Denver’s eclectic bunch of activists together. Whether it’s raising funds for a funeral, for bail, or organizing a march to proclaim that Black Lives Matter, Mama Josie is always there to Defend Denver.

Last year, Josie and her then partner Dave donated their entire savings to pay for the funeral of Ryan Ronquillo, a young man murdered by Denver’s gang unit. After the funeral, they worked tirelessly to organize marches and keep Ryan’s name in the news so that his death would not be forgotten.

After making her activism so visible to the community, Josie found herself tailed by police. Because of her activism on behalf of the Ronquillos, she lost her job, which she dearly loved, providing doula services to families on their journeys to becoming parents.

Not only did Josie donate her own home to use to raise funds for the Ronquillos, she also raised money for the family of Jessie Hernandez, who was killed by the Denver police in January. Like most of the Denver activist community, she found herself mourning the loss of a vibrant teen while also fighting for the freedom of Sharod Kindell.

At a meeting of activists several months ago, the mother and father of Jessie Hernandez expressed, through tears, their love and appreciate for Josie and the tireless work she had done to help them pay the rent, buy food, and bury their child.

Now, Josie finds herself alone. She and her partner of 6 years, the father of her children, are divorcing. Josie is about to find herself without a job, without a car, without a partner, and if we cannot help her through this, without a home. She is looking hard to find work, but continues to pay a heavy price for her activism.

There is no way this amazing, dedicated young woman should lose her home and her independence when she has done so much for her community. Please help us by joining the Circle of Love for Mama Josie, and donating what you can today. Every dollar helps a woman journeying into single motherhood provide for her children and stay in her home.

If you cannot donate, please help by sharing this post on Facebook, Twitter, WordPress, and other social media. Donations of social media platforms are absolutely donations!

Thank you.

“Sexy” Nurse Costumes Harm Nurses

It’s Halloween, the time when people seem to lose their respect for others and find the most offensive costumes ever. It’s this time of year when my Facebook feed, Twitter TL and email fill with ads people think I should see.

Here we go.

Ebola nurse.

ebolanurse2

 

While another photo circling the internet was photoshopped, the above photo was not.

Let’s remember that hundreds of nurses have died from treating Ebola patients in West Africa. Not because they are lazy or sloppy but because the number of patients and lack of protective gear means nurses have a very high chance of disease. Recently, several nurses died of Ebola after caring for a newborn who had the disease. Their choice was to pick up the baby and care for it or leave it in a box to die.

It’s a long shot, but I believe the “Ebola nurse” costume may be the most offensive Sexy Nurse costume of them all. Already I know some person with very poor judgement and a large amount of racism is going to combine a sexy nurse costume with Blackface and call themselves Amber Vinson. That will be the most offensive I have ever seen. If you see it, don’t tell me about it. I don’t want to know.

(Anyone who puts on Blackface, Yellowface, Redface for costumes is out of line. It’s racist and harmful. Period. Don’t do it. Google “should I wear Blackface” and see what you find out)

I am THRILLED that Amber Vinson, RN and Nina Pham, RN have been cured of Ebola. I am THRILLED. They contracted Ebola in the service of their patient and they deserved the best care the US had to offer and I am so glad they got it. I am also glad that there have been no further cases (as of now) out of Texas.

But what the hell are you doing dressing up in a sexy “Ebola nurse” costume when there are nurses in West Africa probably dying of Ebola right now?

About 2 months ago, I received an email from the CDC, asking for volunteers to train and go to West Africa for 4 week periods of time. I did not answer it. I spent most of the Spring season ill with pneumonia and pericarditis. I am not in the kind of shape to go to West Africa and work 24 hour shifts caring for Ebola patients.

But other people did. Right now, Kaci Hickcox, RN, is sitting in a tent in New Jersey, in paper scrubs. New York and New Jersey say this is their plan for healthcare workers who return from treating Ebola patients in West Africa. Humiliating treatment for a person who has spent a month caring for the very sickest of patients, who watched a child die of Ebola her last night in West Africa. This is a person who has risked her life. She deserves better than this.

Sexy nurse costumes are not funny. Don’t wear a sexy nurse costume. They’re disgusting. If you want to be a nurse for Halloween, wear real scrubs. Being a nurse is an honorable profession. and not worthy of being mocked or sexualized.

In the blog post that made my life miserable, “The Effects of Nursing on Nurses,” I talked about the heavy mental and emotional toll nursing can place on a person. That was a post made after three incredibly busy night shifts when I was tired and dismayed at seeing a nurse I admire burst into tears. I’ve had some pressure to take the post down, but I’m going to let it stand because it still gets about 50 views a day. If any of those views are a nurse looking for someone who feels the same way, the post should stand.

Sexy nurse costumes add to the burden nurses already bear.

Nurses are highly trained professionals who put themselves at risk for you and your families over and over again. In my career, I have been groped, hit in the abdomen, smacked in the face, and smacked on my behind. I’ve had a physician slide his hand up my thigh. I’ve been called a bitch and a cunt, by PHYSICIANS. In addition to these physical assaults myself and nurses everywhere are frequently subjected to harassing comments, jokes, and behavior. This IS workplace sexual harassment, and somewhere right now, another nurse is dealing with it. Nurses are expected to laugh off harassing behavior and very few patients ever experience repercussions.

Nurses who are attacked by patients or even physicians rarely are able to seek justice for themselves. I do not know of any cases where a patient has been successfully prosecuted for sexual harassment of a nurses. This is similar to the behavior experienced by waitstaff. Additional cases of nurses who have tried to take on physicians can be found in Suzanne Gordon’s Nursing Against the Odds. I also Tweeted extensively about laws in Texas that do not allow for anonymous complaints against physicians and hospitals. For more information, you can check the #WinklerRNs hashtag, which stands as a reminder to what happens to nurses who whistleblow in Texas.

And last, I’m going to talk about costumes for doctors and costumes for nurses. See below:

sexynursedoctor

Here is another advertisement, this time showing 9 nurse costumes and one doctor costume. Notice the difference? The doctor costume is not hyper-sexualized, it’s respectable. This advertisement is a symbol of how nurses are perceived by the public. When you wear a costume like this, you degrade nurses. If you look back in your life, or talk to your parents, you know nurses. You know someone who works long hours, through the night, and you probably have a story of how a nurse saved someone’s life.

I was wearing a blue plaid shirt and jeans the day I stopped on I-25 near the Colorado/New Mexico border to aid a man who had hit the side of a mountain. He had been flung from his vehicle. As I ran from the South side of the interstate to the North, I saw at least 20 people standing around him. I asked for help, and no one responded.

I quickly assessed the man and noted he had multiple broken ribs, resulting in a flail chest, which compromises breathing. He had a head wound, compound fracture of the leg, and an arterial bleed from his arm. Someone had thrown a towel over him.

I knelt over this man, clamped the towel around the artery, put pressure on his ribcage with my knees and secured his airway. Immediately, he drew in a breath, his color returned and he began to struggle. Still, none of the bystanders would come to my assistance. I was stuck. I was using every piece of my body and strength to hold this man still.

After what seemed like an eternity, the paramedics arrived, listened to my report and took my place. I got back to the car and cleaned up with the bleach wipes I keep there.

Do I deserve to have my image and profession mocked?

That’s what a nurse looks like. Someone risking their life for yours. Don’t degrade us. Don’t mock us with hyper-sexualized costumes. Respect nurses. As someone said on my Twitter timeline last night, “we are here to save your ass, not fuck it.”

Edit: Prior to writing this post, I had not seen any “sexy male nurse” costumes, so I did not include them. I was wrong.

 

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Why We Shouldn’t Be Surprised a Nurse Contracted Ebola in the U.S.

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Note: I have intentionally not linked to NBC’s post about Nina Pham, RN’s nursing experience. Critical care nurses must meet exacting requirements prior to receiving critical care certification. Critical Care certified nurses have already put in the time. Please reference this FAQ from the American Association of Critical Care Nurses

Anyone making comments about the nurse who contracted Ebola and her competence or her thoroughness needs to read this article. If you are a nurse or physician or other healthcare provider who does not work in a biohazard containment facility, you need to rethink. Remember: people who are experts with this clothing get Ebola. Are we surprised that people who are not experts could contract it? The issue is training and skill level. We should not be surprised that people who have never been around Ebola are not experts at containing or contracting Ebola.

(update added at end of post)

I’ve known for years (and I think a lot of people have) that Ebola would get to the U.S, but I still haven’t been afraid of it because you remain more at risk of being shot by a police officer or security guard even if unarmed in the United State than of catching Ebola. Even as a nurse. You are at higher risk to die of diabetes, the flu, or by a drunk driver than you are from Ebola. You have this risk simply because you live in the United States.

But what I DO know… due to my burn scar, I can’t wear a traditional TB mask. I have to wear a PAPR hood. However, I’ve never worn one. I don’t even know how they work. Still, if I had a TB patient, I’d be expected to learn how to care for the hood as well as the patient. I’ve never worn one. That’s…. not comforting. (In addition, workers at Texas Presbyterian were not given Hazmat suits until a positive Ebola test was received).

I think it’s time hospitals,  nursing, and medical schools started adding biohazard PPE training to their regimens. I think the United States should fund this. I think they can do it by reversing the decision to slash the Hospital Preparedness Program from $515 million to $255 milllion in 2014 and the Public Health Emergency Preparedness Program from $900 million in 2005 to $610 million this year. (Links found from “Ebola Highlights Public Health Crisis“)

The United States has thousands of hospitals, all staffed by medical professionals who have dedicated years of their lives to careful education and preparedness for the care of any individual who may be hurt or ill. Is it too much to ask that the United States not ask for actual years off of our lives?

 

Edit:

After initially posting this, I came across this article from Oregon Live  that states, according to records obtained by the AP, Texas Presbyterian did not place it’s staff into Hazmat suits until Duncan’s Ebola test was positive.

 

So:

 

Patient from Liberia: Check

With explosive diarrhea: Check

Vomiting: Check

High fever: Check

Hazmat suits? Let’s wait for blood results.

 

I really hope that article is wrong, but I don’t think it will be.

A Brief History Until Now

People keep asking me “when did you become an activist?” so here’s a brief history

I was born in 1976. Baptized into the Episcopalian Church.

Moved to Nashville in… 1981? I think?

I was burned in 1987.

Took back my name in 1990.

My mother volunteered at political functions, at churches, at homeless shelters. She did a lot to me I can’t forgive but she taught me how to be useful. My grandmother was an active member of the Republican Ladies Association her entire life. She instilled in me the importance of the vote. My mother sent me to Father Ryan High School, which had the unintended result of encouraging me to think for myself. My teachers and host parents in Germany continued encouraged me to broaden my mind.

Went to Germany in 1994.

Graduated high school in 1995.

Started performing poetry in 1996.

Moved to Colorado in 1998. Lost my name again.

I was a Republican until 1999.

A Green until 2000, when I also accepted that I am bisexual.

Sometime around here people started calling me a feminist.

Pre reqs for nursing started in 2001.

Diagnosed with Meniere’s in 2002.

Nursing school in 2003.

Graduated in 2005 (ADN).

Volunteered/worked with OFA from 2007-2008 on the campaign for Obama

Married in 2010.

Volunteered in a small capacity with OFA in 2011-2012.

A Democrat until 2012. Somewhere around here I began to believe I might be a feminist.

Took my name back again in 2014.

I’ve been an activist since the Summer of 2003. The crimes committed at Abu Ghraib were too much. I could not stay silent.

I’ve marched against the Iraq War (which I initially blindly supported),  for Occupy, for Trayvon Martin and other causes. During Occupy, I was one of many people ferrying supplies to Civic Center Park. I’ve participated in Hashtag Activism since a few months after joining Twitter.

I was in college for the last two years (BSN). I graduated August 14th.

Organizational groups need people who can pass out flyers, fill out permits, make phone calls. They need people with first aid and medical training. Working night shift allows me to do these things, as does my 2-3 day a week work schedule. This is what I can do.

I started working with Coloradans For Justice because I cannot stand by and watch the killing of people of color in the United States. I cannot be complicit in acts of war against a group of people due to their race. By being silent, I was being complicit. I cannot be silent.

I will do what I can until the world changes or I die.

 

The volume of my voice is not as important as the amplification I can provide for others who need it.

Just Keep Walking and Why I Stop

Trigger Warning: Racism. Domestic Violence. Violence Against Women

 

My friends who know me, know I stop. I stop for hurting people. I stop for hungry people. I usually don’t have cash or change to hand out but I almost always have some food in my bag. It’s what I can do. I’ll tell you if you need to go to a hospital or doctor or not. One of these days, stopping might get me in trouble, but I’ll probably keep doing it.

It embarrasses my friends.

It embarrasses my husband.

It embarrasses my family.

I keep stopping because I take the role of the nurse in the community seriously. Everyone who knows me knows I’m a nurse. You shouldn’t be shocked. And don’t go #notallnurses on me because we all know there are different kinds of nurses.

I feel guilty about what I’m about to write. I’ve felt guilty for a long time, even though I was a young child when this happened. But I want to speak out about this culture White people have created and what has been adopted. Because ignoring violence against women, especially Black women, is a huge piece of White supremacy that needs to come apart.

It was a sunny day. I don’t remember what time of year. It was in East Nashville. Somewhere along Eastland Ave. We used to live on Benjamin St. I went to Cora Howe Elementary. I think we might have been coming

I don’t remember where we were going but I was walking with my mother. There was an apartment building nearby that had a reputation. Most of East Nashville had a reputation at that point.

A Black woman came running out of the building, screaming for help. A man ran out after her and tackled her, beating her on the ground. I wanted to run to the payphone and call 911. I told my mother we needed to help. She held me harder and said “Just keep walking.”

Now.. was my mother afraid for her own safety? Probably. Was she afraid for our safety? Probably. But could she have knocked on a door or done SOMETHING? Yes. My mother worked for the Metro Nashville Police Department for years. She wasn’t a police officer, but her call would have brought half a squad. I’ve seen it happen.

And she didn’t. She walked us to the car, she got in, and she never looked back. We lived close by. She could have driven home and called for help and never identified herself to the abuser. She didn’t.

I remember that woman. I remember she had long, natural hair. I remember this because the guy used her hair as a weapon. It was how he stopped her before he tackled her. I remember her screaming in our direction, because we were the only people out there. But I don’t know what happened to her.

I also remember my mother  and step-father(s) abusing me and my sister.. I remember when we tried to get help because our parents had threatened us with beatings if my sister failed a test. My sister, suffering from undiagnosed dyslexia, failed the test. My sister is INCREDIBLY smart. She’s just dyslexic. But when we went to the Kroger on Gallatin Rd, that had a giant “Safe Place” sign in the window, we weren’t helped. The police jumped to help one of their own. My sister and I were taken to a counselor, we were never allowed to speak without our parents present, and we were told if we persisted with our complaint, we would be split up, pulled from our school (the only haven we had), and how selfish we were to accuse our parents of these behaviors. I remember how we went to subsequent “therapy” appointments after that, where the therapist called us lazy and told us we had to do more to help our mother. Our abuser. Again, we were not allowed to speak without our parents present.

So now I stop. I call 911 if it’s needed. I help. If I need to, I’ll scream my head off to draw attention to what’s happening. You don’t get to abuse someone near me and feel that’s it’s okay because no one stops. I’m going to stop. If I can’t stop you myself, I’m going to get someone who can. I couldn’t stop when I was a little girl, but I can stop now.
Making rules for yourself and standards for the people you associate with IS NOT easy. It doesn’t even really get easier. But it does lead to a more fulfilled and honest life. I’m not done learning, changing and growing. But learning to stop was one of my earliest rules for myself as an adult, and it’s a good place to start.

Concerns and Suggestions About the Future of the ADN and the BSN

I am finishing my BSN, FINALLY, and I have …. concerns

When you view the chart, realize that the higher in the chart you are, the fewer years of experience you are actually receiving.

 

Above is a link to a rough post where I have graphed a very rough flowchart of where I think nursing is heading. I believe current goals will result in a forced exodus of experienced nurses from existing acute care facilities when they are not able to accommodate their schedules and finances to higher education.

I believe the push for higher nursing education is a good one, but if hospitals want to keep their best nurses, they need to begin to formulate a plan that sets aside paid time for educational goals and work with universities to bring the needed education into the hospital. BSN programs need to be closely reviewed to be sure the information they are teaching ADNs is relevant to practice and the goal should be to increase knowledge of the ADNs instead of simply fulfilling the core tenants of a Bachelor’s degree. In a utopic situation, the course would be created so that ADNs coming into a BSN program would actually emerge with a certification reflective of their years of experience and knowledge and placing them higher in the nursing hierarchy than new graduate BSNs with no experience.

Yes. This will require hospitals to pay nurses floor pay to attend classes. The hospitals will benefit with higher patient satisfaction scores, lower patient injuries, and better physician/nurse relations. Many hospitals already offer education assistance and scholarships in exchange for time worked after graduation. This does not need to be any different.

If nurses have time set aside for classes that they are attending with their coworkers, they have a ready made support system, which is necessary for successful education. If nurses are allowed to work fewer hours on the floor while they are receiving their education, advancing ones education will not appear so monumental and burdensome.

As far as funding these paid hours that are performed off the floor, hospitals should look to their political force. This is a viable method that can be used to increase the knowledge and the size of the nursing force, at a time when an influx of patients threatens to cripple the current United States medical system. Nurses will emerge from these programs empowered, better team players, and will receive knowledge they can apply to the bedside at their next shift rather than trying to find time to take off work, struggling through APA format and trying to find a way to pay for their own college education as well as that of their children.

No ADN currently working full time should be forced to carry a burden of student loans to maintain their current career. This is a burden that many nurses with families and current student loan debt cannot handle. Instead of requiring 2 years of work in order to receive student loan relief, while paying student loans, give the relief IMMEDIATELY, and require nurses to pay back a prorated sum if they leave the area or change careers.

It is my belief that this kind of incentive is what is needed to get ADN nurses into BSN classes. Current BSN programs focus on papers and theory, but there is very little meat added to the pot of  nursing experience already held. This is a waste of the time of experienced nurses. Because it has already been decided that management roles should be held by holders of nursing doctorates and master’s degrees, only individuals who are interested should be required to take additional classes in nurse management.  Nursing programs need to be divided into tracks: Research. Management. Advanced Care. Hospital Management.

Instead of this, we have nurses sitting in History, Music and Philosophy classes to earn their BSN. All of these are valid courses of study but are they actually efficient for people whose priority is to get back on the floor? Nurses who have an ADN and have years of floor experience do not necessarily need these classes but could use classes in new techniques, evidence based practice, and advanced practice.

As a floor nurse who has worked in multiple hospitals, including LTAC, rehab and nursing homes as I made my way up from being a tech to a RN, I feel the the nursing profession is missing a valuable opportunity to increase the abilities of their current workforce while making nursing a more rewarding experience.

The History of Breastfeeding Among Black Women – What White Nurses Need to Know

If you are a nurse, particularly a white nurse, working in postpartum or NICU and teaching new parents how to breastfeed, it is vital that you understand the history of breastfeeding among Black women. Up until late in the last century, Black women were still employed as wet nurses for White families. This robs a Black woman’s own child of nutrition. It also explains why many Black women have a negative connotation with breastfeeding. Rather than blindly push forward with lactation education, nurses need to work to further develop cultural competence and understand why Black women may choose not to breastfeed, and why their relatives may encourage them NOT to breastfeed.

Ultimately, breastfeeding should be the choice of the individual involved, not the choice of a nurse or family members surrounding the new parent.

@FeministaJones made a series of tweets regarding the history of breastfeeding and black women, as well as the history of how Black nurses were treated in homes. It is hard to read, but necessary to learn. I storified the tweets yesterday, but am also placing them here so that I can quickly point to them.

ago

On Black Women and Breastfeeding

In her #WomensHistoryMonth discussion, @FeministaJones discusses the history of Black women and forced breastfeeding of White children in the United States, up to modern times, pinpointing reasons for low levels of support among Black men for breastfeeding among Black women today.

  1. If were going to talk about #WomensHistoryMonth, can we tell all of the stories, please?
  2. Check out the link in that last tweet. Jarring images of the history of Black women as caretakers of White children
  3. “Recent study, 54% of black mothers breast-fed their infants from birth, compared with 74% of white mothers and 80% of Hispanic mothers”
  4. One has to wonder where the suffrage movement would have gone without Black nannies at home raising their children while they marched…
  5. @FeministaJones breast feeding my son was a trigger 4 my grandmother. I couldn’t figure out why she was so upset but now.. that pic #tears
  6. The only acceptable feeling when shown images like those, IMO, is rage.
  7. Maybe I can spark enough rage to incite a revolution…
  8. When I discussed the idea that Black women, esp in the 60s and 70s were largely anti-breastfeeding bc of being forced to nurse White babies
  9. People suggested I was too militant and talking crazy but… I’m right.
  10. There was, on the part of many Black women, an outright rejection of breastfeeding bc of what it meant to them historically.
  11. Racism kept many of us from giving our children the nourishment they needed from us. Let that wash over you.
  12. We were forced to give milk produced for our own children to the children of our owners, forced to neglect the needs of our babies
  13. Then we were blamed when our babies got sick or died and called “bad mothers”.
  14. The connection btwn Black American women and breastfeeding has not always been positive and BF advocates have to know this.
  15. So when I see WW, esp, coming down on BW for not breastfeeding, I cringe… it’s clear they’re not employing culture competence
  16. I say barely half of Black women breastfeed, after several tweets talking about why (including historical violence) and then…
  17. When BW were working and out of the home 16+ hours a day or barely allowed to go home to their children at all, how were they to nurse?
  18. BW had few choices but to NOT breastfeed and supplement their babies’ diets with whatever was available.
  19. And yet… BW have been perpetually vilified as being “bad mothers” when they’ve been forced into these conditions
  20. @FeministaJones So would their relationships with their children, esp. from having to nurse & nurture White children at expense of their own
  21. Re: #LRT, but BW were called “bad mothers”! Without acknowledging how much mother-child connection was sacrificed for work
  22. Only in the last 20 years or so have we seen a significant cultural shift among Black women to nurse their own children, thankfully.
  23. Because, real talk…? Sistas in the 50s, 60s, and 70s weren’t nursing, in large part bc they worked so hard and so long away from home.
  24. And the stigma of BFing was “thats for them White babies”, which we can see how it came from resentment of forced nursing of White babies
  25. @FeministaJones I see that as yet another form of economic violence. Formula isn’t free but we couldnt nurse cuz we had to work so much.
  26. Let your mind wrap around one woman demanding that another woman take the milk she is producing for HER own baby and give it to hers
  27. Breastfeeding, in the mid-late 20th century, was somewhat of a privilege for those who could afford to be around their babies
  28. How can we demonize economically disadvantaged women for NOT breastfeeding at a time before pumping, packaging, etc?
  29. That was passed down through generations and only in the last one, w/advances in BF support tools, are we seeing more BW embrace BFing
  30. My mother and all of her sisters formula fed. No one breastfed. My mom asked “What formula you plan on using?”
  31. Cultural competence means not assuming a new Black mom is automatically taking the “Duh of course I’m breastfeeding” approach
  32. It means understanding that our historical connection to breastfeeding is one of oppression, violence, and denial of “womanhood”
  33. “From 2000–2008, the percentage of women who initiated breastfeeding went up from 47.4% to 58.9% for blacks”  http://www.cdc.gov/breastfeeding/resources/breastfeeding-trends.htm …
  34. Like I said, this is a relatively new cultural shift and it’s important to unpack and respect the negative connections to BFing
  35. @FeministaJones My aunt was a “wet nurse” in the 80s in the south. When people act like this stuff is archaic…it’s not.
  36. @FeministaJones That’s why I am always so wary of white women organizing and educating BW on BFing. They gotta do the knowledge!
  37. Not just for Black women, for Black men as well. So yeah… we gotta unpack this stuff.
  38. #WomensHistoryMonth The story of the Negro Nurse (an oft-overlooked figure in American history)  http://docsouth.unc.edu/fpn/negnurse/negnurse.html …
  39. “It’s a small indignity [..] no white person at the South ever thinks of addressing any negro man or woman as Mr., or Mrs., or Miss”
  40. ” It is a favorite practice of young white sports about town–and they are not always young, either–to stop some colored nurse +
  41. ” inquire the name of the “sweet little baby,” talk baby talk to the child, fondle it, kiss it, make love to it, etc., etc.+
  42. “and in nine of ten cases every such white man will wind up by making love to the colored nurse and seeking an appointment with her.”
  43. So remember when I said that not standing up to defend Black women is a behavior learned and socialized into BM?
  44. And how, historically, when Blk men stood up to defend Blk women, they faced violence, imprisonment, or death?
  45. If every time you tried to defend a Black women, you were on the receiving end of violence, what might you do, eventually? Stop.
  46. “If their fathers, brothers, or husbands seek to redress their wrongs the guiltless negroes will be severely punished, if not killed” Oh
  47. When I hear “Black women ain’t worth it…” talk, at the end, I hear the unspoken laments abt the repercussion for making us “worth it”
  48. It gets passed on… it’s self-preservation…it has to be unlearned
  49. If we loop Black men into the BF discussion, we have to ask how many are supportive of BFing and the economic implications for them
  50. We have to think about how maternity leave affects Blk families where the men are struggling to find work. That’s loss of wages…
  51. And if women feel they have to hurry and get back to work, they might not opt for BFing if formula feeding is easier.
  52. Reading the nurse narrative, I wouldn’t be surprised if BFing was a trigger for Blk men back then too, in light of the WM “advances”
  53. I wonder if any BM discouraged BW from BFing bc it reminded them of maybe what their own moms went thru as wet nurses for WW
  54. Hard to think of breastfeeding as violence against women, but for Black women in America, the history shows it has been.
  55. !! RT @Alivada: @FeministaJones keeps periods at bay too …in an era pre bc …so if partner was wet nurse, couldn’t parent themselves
  56. If BW were forced to keep lactating for wet nurse purposes, the impact on their own fertility/reproduction would likely be great.
  57. So that’s my #WomensHistoryMonth chat for the weekend.

Calling Out Vs. Calling In: How Activist Techniques Can Be Used to Decrease Lateral Violence and Bullying in Nursing

A little while ago, I had the privilege of reading Calling IN: A Less Disposable Way of Holding Each Other Accountable by Ngọc Loan Trần. The essay is well written and thought provoking, and brought a new idea to the way I practice feminism and activism. I keep thinking back to this essay and what it could mean in my personal life. What if we brought Trần’s idea of “Calling In” to nursing? Could we find a method of speaking to each other that comes from a place of concern and love? When speaking from that place of concern, could we use language and tone in such a manner that lateral violence and bullying on our hospital units is decreased? Could we actively support one another to improve our patient care without bringing someone to tears? I think we could.

From the essay:

“Most of us know the drill. Someone says something that supports the oppression of another community, the red flags pop up and someone swoops in to call them out.

But what happens when that someone is a person we know — and love? What happens when we ourselves are that someone?

And what does it mean for our work to rely on how we have been programmed to punish people for their mistakes?

I’ll be the first person and the last person to say that anger is valid. Mistakes are mistakes; they deepen the wounds we carry. I know that for me when these mistakes are committed by people who I am in community with, it hurts even more. But these are people I care deeply about and want to see on the other side of the hurt, pain, and trauma: I am willing to offer compassion and patience as a way to build the road we are taking but have never seen before.” (Trần)

While Trần’s essay deals primarily with actions within the activist community, I see a lot of parallels with nursing. A good example is shift report. Generally, report is a smooth transition, performed by thousands of nurses each day to get one shift in and another shift out. Everyone’s goal is to get through report quickly so the oncoming nurse can get to work and the offgoing nurse can get some sleep. Report isn’t always seamless, and a big part of that comes from nurses. There are nurses who approach report aggressively, and by the time the offgoing nurse has finished, that nurse feels like they have been through a battle. This is lateral violence.

There are nurses who seem to look for mistakes and consider themselves blameless. Now, we are all going to make mistakes, and because we all make mistakes, we are all going to FIND mistakes. Some mistakes are big, and have a lot of people involved. Some mistakes are small, and are the result of action or inaction by one individual. Regardless of the level of mistake, we should never berate one another or treat one another in a hostile fashion. Rather, we should deal with the mistake, and if we are in the presence of someone who has made a mistake, we should not talk to them as if they did not have a nursing education. We should keep in mind that this is our co-worker, someone we trust and have worked with as a team member. We should tailor our language and our tone to maintain professionalism, patient confidence, and the relationship of trust we have built as members of the patient care team.

When another nurse is aggressive during a nurse to nurse interaction, it is lateral violence. When a nurse is aggressive toward a CNA or other member of ancillary staff, it is BULLYING. This happens to CNAs more often than nurses are willing to admit. It can happen as a result of stress. It can happen as a result of miscommunication, but it happens. We need to be aware, as nurses, of the potential we all hold to be bullies on our units, and to watch our tone, watch how we delegate, and to be aware when our CNAs simply cannot handle one additional task, and that we need to do something ourselves. We are ALL working hard. When viewing bullying by a nurse to ancillary staff, it is important to speak up and stop the bullying behavior. Trần’s idea of “calling in” gives us a new technique to use when we see bullying behavior in a co-worker for whom this behavior Is abnormal. What is causing the behavior today? What can we do to stop the behavior and save the relationship between the nurse and the ancillary staff?

So what is the difference between calling out and calling in?

Trần works to define (and states this is a work in progress):

1) “The first part of calling in is allowing mistakes to happen.”

(Now, in nursing, if we see a medical error about to happen, if we see a safety issue, we should always speak up. I am not advocating that we allow preventable medical or safety errors to happen. In nursing, we should be aware that mistakes will happen and we will have to deal with them, but it is how we deal with mistakes that either brings us closer together or pulls us apart)

2) Think about “what makes my relationship with this person important?”

            Are they a long time co-worker? Are they a new graduate? Are we friends? Do we know they’ve been having a rough time lately? What do we know about our co-worker that makes them valuable?

How do we start these conversations? Again, Trần has put a great deal of thought into this, and nurses do not need to stretch far to see how Trần’s model could be used to decrease lateral violence and bullying on our units:

I start “call in” conversations by identifying the behavior and defining why I am choosing to engage with them. I prioritize my values and invite them to think about theirs and where we share them. And then we talk about it. We talk about it together, like people who genuinely care about each other.”

Additionally:

“I picture “calling in” as a practice of pulling folks back in who have strayed from us… Calling in as a practice of loving each other enough to allow each other to make mistakes; a practice of loving ourselves enough to know that what we’re trying to do here is a radical unlearning of everything we have been configured to believe is normal.”( Trần)

Trần discusses how we have “configured to believe it’s normal to punish each other and ourselves without a way to reconcile hurt.” This is where nursing needs to look up and examine itself closely as a profession. Too often do we see a mistake and rather than deal with it quietly, we mention it to our co-workers. We say “someone was having a bad day” or make comments that lead others to believe our fellow nurses are now not as trustworthy as they might be. Comments like these undermine nursing as a profession. They undermine the teamwork on our units, and they break down the relationships among nurses.

It should not be “normal to punish each other.” Instead, when a mistake is noted, deal with it. If the mistake needs to be reported, do so quietly and efficiently without involving others, if possible. If you need to involve someone, involve someone who will also be discreet. Offer your fellow nurse a shoulder, support them if they need to take a moment for self-care. Be aware of the signs of compassion fatigue or burnout.

By incorporating the idea of “calling in” rather than calling out, we can decrease the incidence of lateral violence and bullying on our units. We can make our workplace more professional, and less stressful. We can encourage each other to participate in self-care to stay mentally and physically healthy. We can be better nurses, and we can elevate the nursing profession.

I would like to address the issue of “calling in vs. calling out” as it relates to ancillary staff. If a nurse finds an error made by a CNA, “calling in” can still be very useful, but nurses need to remember the potential for bullying in these situations. There are different power dynamics involved with nurse-CNA interactions than with nurse-nurse interactions, and the potential for harm here must be acknowledged. Remember how humiliating it can be to be “called out” at the nurse’s station, in a patient’s room, and afford all of your co-workers the same respect, and do not use these power dynamics to better yourself, but to better all staff.

What About the: Respiratory Therapists?

Ready for a happy story?

Respiratory therapists are responsible for a lot of things all over the hospital. When they are on our floor, I can hear their phones ringing to call them to another floor. We see them doing treatments frequently, we call for help occasionally, and they are always included in a rapid response (a team effort to get to a deteriorating patient and avoid a code).

I am good with trachs, due to extensive training while I was a tech, and later homecare experience. So I am very comfortable with suctioning and trach care. Often, if the RT is very busy, I’ll do as much as possible to make their night smoother. I also volunteer to take the trach patients as often as I can because I know most of the nurses on my floor don’t like trachs. These patients often request for me to be their nurse again and again, and I do. It helps that I’m an excellent lip readers and intuitive. I rarely feel fear with a trach.. it’s a stable airway.

Recently at work, I felt helpless. It was a busy night, I had a 6 patient load with some really heavy patients.  My patient was deteriorating and a call to the resident was fruitless. I suctioned, but it was like tar. It was bad. My patient was grey. The oxygen level was okay so far but  could get worse at any moment.

For the next 1-1 1/2 hours, two incredibly knowledgeable  RTs worked over my patient, performing procedures I’d never even heard of. They told me what medications to get from the doctor. I phoned and phoned and phoned. I brought the meds in. I medicated the patient for pain. Other respiratory therapists in the hospital started to pick up their work, but I know they got behind.

It’s the middle of the night in the hospital. We ran out of suction catheters. The house supervisor went to central supply and when she couldn’t find what we needed, so she called floor after floor and suction catheters start to appear. We were good.

I was so impressed by the variety of the things they could do, and within that hour to hour and a half, my patient began to breath better. Partially from pain medication, but mostly from sheer force of will. We are all very bonded to this patient and he to us.

I was also impressed by the nurses and CNAs who left their floors running with the equipment we so desperately needed.

When I left that morning, the patient put out a hand. Thanked me for all I did. I said
You’re welcome, but it was a team effort and you are the most valuable player in the team.”

A lot of times, you’ll have a bad shift and you’ll feel you didn’t give the best care, and you’ll say to the oncoming nurse “well, they’re all breathing.” It’s nurse code for “I could only do the bare minimum, but we all survived, can I go home now please?

That night, I learned more about what respiratory therapists do. Like nurses, they run hard, unlike nurses, they are spread throughout the hospital covering several floors at a time. I knew they were smart, good in a crisis, but I am so moved by gratitude.

When I left work, everyone was breathing. And that is because the respiratory therapists I work with put their feet down and said “no.” It was a rough night, but we gave excellent care. And honestly, I don’t begrudge that patient my break (I did manage to eat). In a perfect world, nurses could get breaks everyday but medicine is by its own nature an imperfect science, and while I complain if I don’t consistently get breaks, it is absolutely worth missing a break to improve your patient’s health.

I plan on writing a series of blog entries about my interactions with other medical professionals. As with my patients, I will not name names or identifying features. The only person’s privacy I am giving up is my own.

 

Update on – The Effects of Nursing on Nurses

I’m going to address a few things I read repeatedly in the comments of my original post:

What about the CNAs/PCTs/Aids/etc? I was a tech prior to becoming an RN, while I went through nursing school. I personally know how exhausting and backbreaking the job of a tech can be. But this post wasn’t about CNAs, it was specifically about nurses. CNAs do not have the same responsibilities nurses carry, although we share many of the same tasks. The RN is ultimately responsible for the task to be completed, and will be held responsible if it is not.  I do recommend CNAs take time to practice self care and realize when they are overly stressed, or if a patient is being abusive . I have personally seen patients abuse a CNA who would not abuse a nurse. CNAs are not mindless automatons, they are living, breathing people with a lot of their own responsibilities, and deserve to be treated with respect by nurses, doctors, and patients. Ultimately, my blog post was about nursing, and because I was not dealing with a  CNA at the time, CNAs were not mentioned in my post.

If I don’t like my job, I should quit it. Also, I should have known nursing was hard when I went into nursing school. – I’m not going to quit my job. I’m very good at my job. My blog post was about encouraging all nurses, including myself, to practice self care techniques to avoid the effects of compassion fatigue. For those who are unaware, compassion fatigue is not the same as burnout. Compassion fatigue is the result of repeated exposures to extreme stress over time. When units have high levels of compassion fatigue, they have higher incidents of falls, medication errors, and infections. Nurses suffering from compassion fatigue do not answer call lights and alarms as quickly. Compassion fatigue is a real issue among healthcare providers. The recommended treatment for compassion fatigue is time away from the source.

If every nurse who suffered from compassion fatigue, stress, frustration or burn out left nursing, healthcare as we know it would be irrevocably changed.

I’m a nurse. I’ve never called in sick, taken a mental health day, or complained about the long hours and working holidays.

Congratulations. Maybe you should write your own blog post about the stressors you experience on the job, and how you deal with them so the rest of us can learn. Maybe you are one of these nurses who practices lateral violence, and are part of the problem.

Other healthcare professions experience the same thing. Why weren’t we included in this post?

I’ve said it repeatedly in the comments: this post was about a specific interaction between nurses. Other healthcare professions certainly experience stress, compassion fatigue, and lateral violence. We all have a lot of responsibilities. I cannot write about problems experienced by respiratory therapists, paramedics, EMTs or other healthcare workers because I have only been a secretary, a tech, and a nurse. I write what I know. If you would like to write a blog entry about your specific profession, I would be happy to link to it on my blog.

Since last August, I have taken several steps to improve my personal stress level and mental and physical health. Because I am attending a BSN program that has clinicals, and am very fortunate to have a very supportive spouse, I have decreased my work hours for the next several months while I have nursing clinicals. This will also allow me an opportunity to help my feet heal, as the pain during work is quite significant. I realize not everyone can do this, and that I am very fortunate. I will still be spending 36+ hours a week on the hospital floor, as well as time in classes, so I will remain pretty busy.

I would like to recommend some reading for those interested in the problems facing nurses

From Silence to Voice: What Nurses Know and Must Communicate to the Public – Bernice Buresh and Suzanne Gordon

Nursing Against the Odds: How Health Care Cost Cutting, Media Stereotypes and Medical Hubris Undermine Nurses and Patient Care – Suzanne Gordon

Bribery

It’s happened to nearly every nurse I know. You work your ass off for a patient, and at the end of the day, the patient or family member try to give you a large cash sum in thanks for your work. I’m not talking about a $5 gift card to Starbucks, I’m talking about a gift of over $50 cash, or of a great deal of worth.

I remember caring for a woman who had emergency surgery but also had Alzheimer’s. She was traumatized to be out of her nursing home. She refused to eat anything. I worked with her for 3 days, helping her walk, making sure she didn’t fall, bathing her, and ordering different foods until I found something she would eat. It involved calling the nursing home and finding out from their staff what her favorite foods were.

I became close to her family over this time. Her son repeatedly thanked me for all my work, which was really nice. He nearly cried when his mom started to eat a peanut butter and jelly sandwich, cut into perfect squares. Every morning when he arrived and saw her clean and cared for, he knew his mom was safe.

At the end of my third shift with this pleasantly confused and challenging patient, her son pulled me into a corner and tried to give me $100. “Take your husband out to dinner.” I politely refused, and told him his thanks was more than enough. He insisted he wanted to give me a gift, so I suggested he send the floor a fruit basket, something we could all share. He begged me to take the money, but I told him it wasn’t right, because caring for his mother was my job. He said I did more than my job, but nurses know, I may have gone a little bit above and beyond, but not far. I politely said no a third time, and told him to take his own wife out and relax now that his mother’s health crisis had passed. He finally agreed.

After the patient was discharged home, multiple fruit baskets arrived for night and day shift, for each side of our unit. Everyone was really happy about that.

Not taking money from patient family members is one of the basics of nursing ethics. It could be construed as a bribe to give one patient better care than another, which I just won’t do. You get care based on how much care you need, not how much care you can afford.

So imagine how I feel every time I hear about a politician taking bribes for things like hot tubs, home repairs, vacations, etc.

It makes me want to vomit. Consider Bob McDonnell, who has been accused of taking multiple bribes. He makes enough money. He didn’t need those things. If it comes out to be true, it’s going to be horrible.

I am always amazed at the frenetic energy the wealthy or well-to-do spend on BECOMING MORE WEALTHY. You already can support yourself in luxury. The governor gets free food! A mansion! After he’s done, he’ll have speaking opportunities, book opportunities, maybe a pension (I don’t know what happens to Virginia governors after they leave office). Before this bribery scandal, even becoming Vice President was a realistic option. Instead, he had to take money and services from people.

Shame on Bob McDonnell, and shame on every politician who takes bribes. I’m not even talking about funding for political campaigns, I’m talking about out and out bribes. Shame on you. I would never solicit bribes from a patient or family member, how dare you do this to your constituents, who look up to you.

Vanderbilt Hospital In Nashville Has Nurses Doing Housekeeping

Source Here

NASHVILLE, TN (WSMV) –

Vanderbilt University Medical Center’s latest budget moves mean nurses will be responsible for a lot more than patient care.>

The Channel 4 I-Team has learned some Vanderbilt nurses will now be in charge of cleaning patients’ rooms, even bathrooms.

Sanitized environments in hospitals are critical to a patient’s health, but the new cost cutting measure has at least one nurse concerned.

“Cleaning the room after the case, including pulling your trash and mopping the floor, are all infection-prevention strategies. And it’s all nursing, and it’s all surgical tech. You may not believe that, but even Florence Nightingale knew that was true,” said a hospital administrator to staff in a video obtained by the Channel 4 I-Team.

The new cleaning changes were also detailed in an email sent to staff of the Vanderbilt Medical Center East team, which – according to a hospital employee – works in surgery areas and patient rooms.

A manager writes in the email, “We have undergone some major budgetary changes … this means we will need to pull together like never before.”

The email says nurses will now have to pull their own trash and linens, sweep up and spot mop. Nurses, care partners and nursing assistants will be responsible for all patient care areas.

“The priority will be what the patient sees,” the email states.

Also, in bold highlighted text, the email says, “Be sure to wear the appropriate [personal protective equipment] when doing any disinfecting – that includes, a cover up gown, gloves, mask and even an eye shield when necessary.”

Nurses were also told to “refrain from speaking negatively about this in an open forum where our customer can hear. If you need to vent come see me.”

The hospital employee did not want to be identified for fear of losing her job but wanted the public to be aware of the changes.

“This is our new reality. The work still must be done. We must still care for patients, and we must do so in an efficient manner,” the hospital administrator told staff in the video obtained by the Channel 4 I-Team.

The nurse to whom we spoke says before these changes, the hospital’s environmental services department was in charge of cleaning those patient areas and that staff does not have interaction with patients.

The nurse is concerned that doing both cleaning and patient care could lead to cross contamination.

The email obtained by the Channel 4 I-Team does say environmental services will still be handling some cleaning.

In a statement, Assistant Vice Chancellor John Howser, said:

“The safety of our patients is always of foremost concern. All decisions about operational process redesign at the Medical Center are being made in a patient-centric manner and will not affect the safety of patient care.”

The Tennessee Department of Health says it does not specify how a hospital chooses to clean, as long as the employees are appropriately trained and follow CDC guidelines.

If they do that, the state says there should not be any increased risk of infection.

We checked with Lipscomb’s nursing staff. The executive associate dean of nursing, who has been a nurse for 25 years, says she hasn’t heard of a hospital doing this before.

Copyright 2013 WSMV (Meredith Corporation). All rights reserved.

This really bothers me. As nurses, we already have hundreds of responsibilities, and I believe Vanderbilt’s choice to have nurses clean toilets and mop floors may lead to cross contamination as well as an increase in patient falls and medical errors. I am certain they are not going to decrease the nurse:patient ratio in order to make this change easier on the nurses. Vanderbilt is looking for ways to slash jobs, so they are getting rid of EVS because they can only legally get rid of so many nurses.

Especially insulting is the implication that Florence Nightingale would have wanted nurses to return to doing housekeeping in the hospital. Nightingale wanted nursing to move forward, not backward.

Please help me get this out on social media! Retweet, reblog. Post it on Facebook. Don’t let Vanderbilt harm patients and nurses this way! Use the #Vanderbilt hashtag.

The Effects of Nursing on Nurses

Hi, welcome to my blog post. I have never had a blog post get more than 50 comments, so I am a bit overwhelmed. After responding to many comments, here is a note:

Note: I wrote this blog entry at the end of my 3rd 12 hour shift in three days. I was tired and I was emotional. It is a blog post, not an “article.” It is not researched or sourced, it is purely opinion.

The point of this post is that nurses (and many other professions) need to take the time to practice self care and to encourage one another to practice self care.

My biggest mistake in this post (and there are many) was to use “her” or “she” when I should have used “they” or them.” I ignored my male coworkers, and I should not have. You have my apologies, and I have corrected the post. I have left “she” and “her” in place in the portion where I talk about my coworker.

I have read every comment posted and deleted some very nasty comments that were not helpful to conversation. If you feel this is the place to spew your vitriol, it is not.

 

August 11, 2013

This morning, while I was giving report to the day shift nurse taking over my patients, she burst into tears.

She’s going to miss her children’s hockey play offs due to our strictly enforced every other weekend schedules. You work every other weekend, no more, no less, unless you are going to college (I work every weekend because I’m in college). She’s their hockey coach, and inevitably, each year, their last game falls on a day their mother has to work. I’ve come in early for her before.

So I offered to come in on my night off for an hour and a half so she could get to the game. I’m coming in that early because I know she won’t be done charting.

She turned me down until another day RN got involved. I reminded my coworker I only live a mile from the hospital, and it really wasn’t a big sacrifice for me. She finally agreed, and calmed down. We got permission from the charge nurse.

Nursing is one of the largest professions in the world. If you don’t know a nurse, I’m really surprised. Nurses talk a lot about the rewards of nursing. Catching that vital sign, saving lives, providing comfort, but nurses, by nature, are taught to martyr themselves on the altar of nursing.

When I was a new grad, I hated coming to work so much that I would wish I’d get hit by a car on my way to work just to get out of work. One night, while checking medication sheets, I confessed this to some experienced nurses and found out some of them still felt the same way.

In nursing, it is NORMAL to have days where you wake up and just can’t mentally and emotionally face the day at work. I swear, the only other people who can understand this are nurses.

Nursing is emotionally, physically and mentally taxing, and some days you run too low on what you can give emotionally, physically and mentally. That minor back injury you don’t want to report to HR because you don’t want it on your record. Having a patient with constant diarrhea who can’t get out of bed and needs to be physically rolled and cleaned several times an hour. The cold you got from the two-year old someone brought in. The sorrow that comes from supporting someone who has just found out they were dying, holding in your own tears so you could wipe theirs. In one day, all of those patients could be yours.

I don’t know a nurse who hasn’t taken a mental health day. Some do it by requesting more vacation than others. Some do it by calling in sick, but it’s all time off because we are too drained to give anymore.

So if you know a nurse, and that nurse mentions to you that they feel like calling in because they just can’t take it another day, don’t give them a hard time. Especially if you have an 8-5 job with weekends off or some other really great schedule. The 12 hour shifts nurses work mean we miss the entire holiday we work with our families. Night shift nurses have to choose between holiday dinners or sleep. Often, if a nurse chooses to sleep rather than go to the holiday dinner, guilt ensues. Even though I’ve told my mother-in-law repeatedly that every nurse has to work holidays, she makes a point to say how horrible it is my husband has to be alone for a few hours. What about me? Working my ass off while everyone else celebrates?

We work hard. We are intentionally understaffed by our hospitals to improve profit, even if the hospital is a non-profit. We help people at the worst times of their lives, and often have no way to debrief, to get it off our chests. We don’t just bring warm blankets and pills. We are college educated, degreed professionals who are often treated like uneducated, lazy servants. We get sexually harassed by our patients. We get groped, punched, cut, I even know of a nurse on my floor being strangled (she survived).

Nursing can be rewarding. But nursing is a fucking hard job. If you are afraid of healthcare rationing, you should know it is already happening. Nurses are unable to give everyone the care they need, so patients with smaller problems may not get the same level of care. A nurse may be pressed to only give the minimum amount of care to a patient if they have 5 or more very sick patients. If you don’t want healthcare rationing, talk to your local hospitals about their nurse to patient ratios. Talk to your doctors. If you hear of legislation to support nurse to patient ratios, vote for it. Support it.

So if a nurse needs a day off, you support them. If you’re in a position to help like I was this morning, do so. If you are a nurse, go easier on yourself when you think about the things you didn’t finish, or the things you should have said. It’s a 24-hour a day job and you don’t have to do it alone.

As of January 27, 2014, this post is no longer accepting comments. I am doing this as a practice of self care. Tending to this blog post, several times a day, has become a burden. It has had over 2 million hits, and I am tired. The post has become a platform for people who want to propel their own agendas and are using my space to do so.  Thanks to all who said such nice things, and to everyone else, go write your own blog.

How I Found Jesus by Losing Him, part 2

The start of anything begins with the end of something else.

One day, I was working dayshift, and I got this patient with a bowel obstruction. She was elderly and in really good shape. A real spit fire. She was fucking adorable. It was a busy day. She had an NG tube and we were trying to decompress her bowel with it and disrupt the obstruction.

The morning flew by. My patient didn’t want a shower, but she accepted a bed bath and foot soak from me. If I give you a bed bath, you’re going to feel like you just stepped out of the shower. Cleanliness is important to feel like a human being. It’s also an opportunity to talk to my patients and learn about them, and to do a really thorough skin assessment. Because the skin is the body’s first line of defense, this is incredibly important.

During her bath, my patient told me she would refuse surgery. She told me that at her age, she didn’t want a long surgical recovery. I told her I would support her decision. She thanked me. We talked about a lot of things, her children, her life. She was an amazing woman.

As the day went on, my adorable, spunky patient got worse. She started having increasing pain, clutching her left side. Her abdomen began to swell. Her vital signs deteriorated. I called the residents, and as shift change approached, I took her to ICU. After I gave report and headed to the elevator, I heard a code called in ICU. It was my patient. I was sure she would be gone.

I was off for a day, and then came back to work. It was a Saturday. I discharged a couple of patients and then the charge asked me to take a patient from ICU. The ICU desperately needed the bed, and in order to get that bed, they needed to send us a patient whose death was imminent. When I heard the her name, I said I would absolutely take the patient. The other nurses quickly offered to cover my patients and the charge promised me she would be there with me.

This was important, because I had never had a patient die. I’d saved some lives by making clever catches and having good rescue skills, but the truth is, I’m really good at getting my patients to ICU if they start to crump. I’m even better at keeping them out of ICU by catching slight changes in condition. I’m known for it. Because of this, and luck, I’d gone 5 years in nursing and nearly 10 years in healthcare and never had a patient die.  So I needed someone to stand by me and walk me through the process.

I got report from the ICU. My patient was in a coma, caused by kidney failure. Her bowel had died. They had attempted surgery, which she must have agreed to at the last minute, and found her bowel dead. When the bowel dies, the body begins to fill with toxins. The kidneys lose perfusion and become overloaded. The liver becomes overloaded. Eventually, the individual loses consciousness and dies.

When the patient transferred, I phoned her son to let him know where she was. He was in the middle of a flat out drive across the country to try to make it to his mom before she died. There was no way he would get there.

My patient arrived from ICU and she was barely breathing. Occasionally she would groan and I would give her a very small dose of morphine. Soon, her breathing became irregular, and her heart rate slowed. I knew it was time. I went and got the charge. My patient’s eyes were still opening, so we turned her so she could see the mountains. Then we held her hands, and waited. After a couple of minutes, she stopped breathing. The charge and I told her it was okay to go, I told her that her son loved her, and was thinking of her. I put my stethoscope on her chest and I heard her heart beat a strange rhythm and go quiet. She was gone.

The first thing I did was call her son. He wanted to know if she had died alone. I told him exactly what I wrote above, and he thanked me. His mother had made arrangements, and I let him know I was following those, so he didn’t have to worry.

Then a CNA and I went to work. We bathed the patient. I removed all her lines. We put in her dentures. We did the things people don’t think about needing to be done. I thought how just a couple of days before, I had washed the same woman, the same feet, the same face.I thought about how bright she had been, how full of life, and then I knew. I didn’t know it at the moment, because epiphanies don’t always come quickly, but a seed of change was growing in my heart.

I would love for there to be a God, but I cannot, having witnessed death, believe in a higher power, punishment and reward eternity. I cannot believe in an unforgiving, angry God, or a God that grants wishes. Good and bad things happen, but they happen because of things people do, or because of the existence of gravity, or fire, or electricity, They happen because of human error, and animals. Frayed rugs on wooden floors. Sometimes things happen for a reason, but the reason is that someone has made it happen for their own reasons.

That was the day I started to stop believing in God.

The Hero

I’m not the hero but that doesn’t mean that I was never brave… (Tegan and Sara)

Everyday, I get home, all three cats run to greet me and get loves and treats and breakfast.

Except today, only 2 cats greeted me. Our little orange Maine Coon kitten, Oz, was no where to be found.

I threw my clothes back on and ran around the house, not finding him. I looked outdoors, nothing. I called my husband and yelled “WHERE’S OZ???” at him.

I found in in the cellar. The filthy, coal dust ridden cellar where the furnace, water heater, and Christmas decorations live.

He had meowed until his voice was just a rasp. Then John remembered going into the cellar at about 8 PM last night, after I’d gone to work.

Oz is nuts about his people. He always has to be right near us at all times. I don’t know how John didn’t notice his little shadow was gone.

John also forgot to feed the cats last night, which would have further triggered a “Where’s Oz” thought.

So I walked home from a 12 hour shift, got hysterical, found the cat, and then I had to wash the coal dust and dirt out of my cat. He is not amused. But there were RIVERS of dirt coming off of his paws and belly. Poor lil dude.

I’m so scared of losing any of my cats. Willow and Lilith are pretty terrified of the outdoors, but Oz is curious. I thought maybe he’d gotten out while John brought in the milk.

My mom would give away our pets as kids. She’d hoard too many animals and when the city told her she needed to get rid of some, it was always our pets that went.

My mother once even fed me my pet rabbit. She said she didn’t know I considered it my pet, but I did. If they were going to be food, she shouldn’t have let us name and play with them.

And then, after they kicked me out, I couldn’t find a place where I could have a dog and I had to leave my dog Belle behind. I heard she died, hanging from a fence on their property where they’d tied her. I was so poor, barely making it, I couldn’t afford the dog I’d taken on when I was 13 and didn’t understand. I feel so guilty about Belle.

This was mainly going to be a blog about my exboyfriends, and I’m still going to get around to them, but I’m going to deal with some heavy shit, too. This hysterical fear if I can’t find my cat is not helpful.

 

A Nursing Post

On my first shift as a Registered Nurse, I went into a patient’s room to change her IV fluids. Instead of taking down the bag, I just pulled out the spike, showering myself in D5. The patient and my preceptor laughed so fucking hard.

A few years later, I was taking ice in to do a dermatome check, reached up to grab a glove to put it in, and poured ice down my scrubs in front of the patient and his 5 family members, who laughed their asses off.

For my last JoAnne moment of the day, someone spilled vanilla ice cream on the floor. I came running around the circular nurse’s station, I always move quickly, slipped on the ice cream, went airborne and fell on my ass. I got a standing ovation from the doctors, patients, and nurses, as well as a trip to the ER.

*bows*

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