A Quality Nurse

10 Oct 2006

Look at that cute little girl in her daddy’s arms. I wonder if her daddy wants her to be a nurse when she grows up. That’s my dad and me on my grandparent’s farm at a family reunion, and yes, he always wanted me to be a nurse. He was a very practical man. He said, “You won’t get rich being a nurse, but you’ll always have a roof over your head and food on your table.” My new blogging buddy, The Curmudgeon, at Second Effort asked me if he should encourage his daughters to go into nursing. His questions made me start thinking about the qualities that make someone a good nurse. It’s a question that people have been asking for a long time.

In the 1914 book, “Practical Points in Nursing for Nurses in Private Practice,” Emily A. M. Stoney discussed the qualities of the perfect nurse. Here are samples of what she said:

Qualifications of the Nurse:

“The questions asked by physicians and surgeons before employing a nurse are: Is she neat and clean, and does she understand all the recent antiseptic methods? Does she know what to look out for in the cases under her care, and when to send for the physician? Is she modest in assuming responsibility? Is she faithful to the physician’s orders, and fitted for the cares of a severe and critical illness? All these questions are asked, together with others, and it is a nurse possessing just these qualifications that each one should wish to be.”

Responsibilities of the Nurse:

“The profession of nursing is one in which there is no limit to the good that can be done; it is also one which every woman embracing it must ‘walk worthy of the vocation wherewith she is called.’ A nurse should have such tact, as well as skill, that she will do what is best for the patients, even against their will, knowing how to manage the weakest and most irritable, and doing all that is necessary for them without their knowing it.”

“She must be scrupulously clean and neat in her own person, especially with regard to the arrangement of her hair, which should be smooth and well kept. The office of nurse is too high and too holy for any woman called to it to wish to devote much time to the adornment of her person. Her one object, as regards herself, should be to be clean, simple, neat, modest, sweet-tempered, and to know how to mind her own business.”

Duties of the Nurse:

“The patient should closely be observed, and all that can be done to make her comfortable should be anticipated, not waiting to be asked for anything. The nurse should wear noiseless shoes, and move about the room quietly; she should look where she is going, and not knock against the bed or the furniture; and she should avoid everything that may annoy the patient.”

“The directions of the doctor must faithfully be carried out, and in the absence of directions the nurse should think what he would like to have done. When she makes a mistake, it should be confessed at the first opportunity; the physician will always be found very kind; but if mistakes are left for him to find out, he will naturally lose confidence in his nurse.”

“A nurse should always wear her cap; it is her badge of authority.”

National Nurse News Story

9 Oct 2006

A grassroots organization of nurses is working to establish the The Office of the National Nurse, and the idea is getting a lot of attention from around the country. National Nurse bumper stickers are starting to show up on cars, and major newspapers are carrying stories about the National Nurse Act, sponsored by Rep. Lois Capps (CA-D), who is also a nurse. Go Lois!

Here’s a link to a story appearing in today’s edition of The Oregonian.

I believe that every American deserves a nurse.

Fly Me to the Moon

5 Oct 2006

How time flies when you’re having fun. (Sorry, no pun intended). It seems like it was just yesterday when the summertime temperatures were in the triple digits, and now with Halloween just around the corner, merchants are gearing up for Christmas. Yes, it’s the new American holiday traditional. I’ll never forget when my oldest daughter wanted to go trick-or-treating dressed up like a Christmas tree. If you have a hard-to-buy-for person on your Christmas shopping list, CNN reports that the Neiman Marcus Christmas catalog is full of great gift ideas.

Do you know someone who wants to get away from it all? How about giving them a trip to outer space. That’s right! For a mere 1.7 million bucks, you can charter a trip for six into the wild blue yonder. But wait, there’s more! The package also includes an all-inclusive four-night stay on Virgin Chairman Richard Branson’s private retreat in the British Virgin Islands. The retreat sounds like fun, but I’d pass on the space trip. I get sick on roller coasters. Enough said.

One day nurses will go into outer space. Here’s Cindy, ready for action. She’s traveling to the lunar space station to give first class patient care. Doesn’t she look calm? I bet she’s an emergency room nurse. I’m amazed how E.R. nurses stay cool, calm, and collected even when everything around them is falling apart. Emergency room nurses have nerves of steel. Yeah, they rock!

As you may know, I idolize Nurse Chapel. She could do anything. When she wasn’t pining over Spock or pulling another double shift in Sickbay, she was whipping up tasty dishes in the kitchen. I want this book. It’s the Official Star Trek Cooking Manual: Compiled by Mary Ann Piccard from the Logbook of Nurse Christine Chapel (1978, 1st printing). The Star Trek Cooking Manual contains over 100 favorite Star Trek recipes, all of them galactic, culinary delights. There are recipes for “tempting snacks, delicious main dishes, and luscious desserts from the farthest reaches of the Federation.” The book showcases the favorite recipes of Dr. McCoy, Kirk, Scott, Spock, and the rest of the crew. Recipes for Romulan, Klingon, and Vulcan ethnic dishes are also included in the book.

I’ve always heard that the quickest way to a man’s heart is through his stomach. Maybe that’s why Nurse Chapel was always inviting Spock to her place for a bowl of plomeek soup.

I Love My Job

5 Oct 2006

When I’m at work and I start feeling stressed out, I begin this mantra: “I love my job, I love my job, I love my job.” At first, my coworkers thought I was nuts. I told them this mantra keeps me calm, and if I stay calm, I won’t start screaming in the nurses station.
Don’t get me wrong, I really do like my job, it’s the healthcare system that makes me pull my hair out. As a bedside nurse, I’m frustrated by what I see at work. Our healthcare system is falling apart. It’s dysfunctional, making it harder for doctors and nurses to take care of their patients. There’s a new treatment being used today called “Brief Therapy.” No, I’m not kidding. I think an insurance company came up with the concept as a way of saving money.

When you’re having a bad day at work, do you ever think about getting a new job? Nurses have so many options, the hardest part of getting a new job is deciding which offer to take. Years ago when I entered the nursing profession, nurses had few options; they could work giving bedside nursing care, or work in a doctor’s office, clinic, or school. After a few years, some of my friends left nursing and got married. See our cover girl? She’s trying to decide which path to take. Will she marry Dr. McDreamy or stay in nursing? Only time will tell.

The best thing about nursing is you can quit your job, go into a completely different field, and still be a nurse. Don’t believe me? Pick up a newspaper and look at the want ads, or better yet, go to Nursing Jobs.org for an up-to-the-minute list of available jobs. There are positions available in every imaginable arena.

This is a poem sent to me by one of my former coworkers. She tried my mantra, but it didn’t work for her. She’s now working somewhere else.

I Love My Job
By Dr. Seuss

I love my job, I love the pay!
I love it more and more each day.
I love my boss, he’s the best!
I love his boss and all the rest!

I love my office and its location,I hate to have to go on vacation.
I love my furniture, drab and grey, and piles of paper that grow each day.
I think my job is really swell,there’s nothing else I love so well!
I love to work among my peers, I love their leers, and jeers and sneers.
I love my computer and its software.
I hug it often though it won’t care. I love each program and every file.
I’d love them more if they worked a while.

I’m happy to be here. I am. I am.
I’m the happiest slave of the Firm I am.
I love this work, I love these chores.
I love the meetings with deadly bores.
I love my job – I’ll say it again – I even love those friendly men.
Those friendly men who’ve come today,
In clean white coats to take me away!!!


4 Oct 2006

I’ve been tagged by At Your Cervix. In today’s meme, I am to reveal what five songs I want played at my funeral. I’m sorry, but death is not an option. My employer has forbidden the Grim Reaper from taking nurses who are scheduled to work Christmas. However, just in case Mr. Reaper didn’t receive the memo, here are my top five picks.

To Where You Are, by Josh Groban. This one is a tear-jerker.

Fields of Gold, by Sting.

Over the Rainbow, by Eva Cassidy.

Here Comes the Sun, by the Beatles.

My friends and family may sing any drunken Irish pub song they choose as they dump my ashes into the Chesapeake Bay.

I tag Julie, RN, Sean, Mad Mike, Deacon Barry, and rx850.

The Night Nurse

2 Oct 2006

Painting by Andrew Wodzianski:

Everyone who wants to work nightshift, please raise your hand. What, you say you hate working the graveyard shift? It’s hard sleeping during the day when your kids keep knocking on your bedroom door and telemarketers keep waking you up. Too bad you don’t work with Dracula. If he worked on your unit as a nurse, no one would ever have to float to nights.

If you’re working an evening shift, you pray that the night nurse doesn’t call in sick. That means you have to work until the next morning, and most of us are not nocturnal creatures. Our bodies complain loudly when we break established sleeping patterns. Patients love night nurses except when a night nurse wakes them up to ask if they want a sleeping pill. Some people have odd ideas about night nurses. Yeah, you know what I mean. A nurse working nights may dream about crawling into a patient’s bed, but just to get some sleep, so get your mind out of the gutter.

I detest working the nightshift, making those who want to work nights my hero. And speaking of heroes, even super-heroes need a nurse, and who do they turn to in time of need? The Night Nurse, of course. According to my coworker’s son who collects comic books, no one knows the Night Nurse’s true identity. He also said that she is affiliated with many super heroes, including Spider-Man, Daredevil, and Iron Fist. She runs Night Medical Center, a 24 hour clinic where super-heroes can go to get treated for the injuries, no questions asked. She never charges a fee for her services, but accepts donations. And like any professional nurse, her focus is on the welfare of her patients.

She’s not just a nurse, she’s the Night Nurse.

Dying to be Beautiful

29 Sep 2006

Margie from admitting was on the phone. Her usual bright and bubbly phone voice was subdued. My new patient was down stairs ready to be picked up and she added with a whisper to bring a wheelchair. This girl was in bad shape. Her name was Lisa.

I grabbed a wheelchair out of the hall and scurried down to admitting. Lisa was waiting for me with her parents in a side office. She weighed just over 80 pounds and looked like a refuge from a concentration camp. She was weak. The muscles in her neck could hardly hold her head up. Her face was ashen . Her legs were swollen and red. Her blond hair was dry, brittle, and falling out. She could hardly speak. After signing voluntary admission papers for the psychiatric unit, I took her up stairs to her room.

Lisa typifies so many young women in this country who starve themselves to be beautiful. What is anorexia? Simply put it is the refusal to maintain a body weight at or above a minimally normal weight for age and height. There is an intense fear of gaining weight or becoming fat even though the person is under weight. How common is anorexia? There are many idea about that, but no one really knows for sure. It’s prevalence in the United States is around 0.1%to 0.6% in the general population and several times higher in adolescent girls. In this country women are getting heavier each generation while the concept of beauty is getting slimmer. More than half of American women say they are on a diet. In recent surveys of 5th to 8th grade girls, 31% said they were on a diet, 9% said they had sometimes fasted, and 5% had deliberately induced vomiting.

Lisa was more than a statistic. I was new to the psychiatric nursing field and she was my first anorexic patient. Why did this happen to her? Lisa was the only child of highly educated parents that were both highly respected professionals in the community. They treasured her. She had majored in the arts and was on her way to a highly successful career. She had everything to live for – and she was dying.

I worked with Lisa for 2 years. Her disease even baffled her. She wanted to be “normal” again. She didn’t know how she had become sick. She would look at her frail body in the mirror and see rolls of fat hanging off of her withering frame. I remember her saying “I just want to be beautiful”. Her parents felt guilty. She felt ashamed. We worked with the entire family. She would reach 98 pounds, and be discharged. After a month or two she would come back to us, weaker and more depressed then ever. This was her cycle until she died of a cardiac arrest in her sleep.

Lisa gave me insight on caring for patients with anorexia. She and I took our victories where we could. Instead of allowing her to focus on her guilt, for not gaining enough weight to meet her goal, we would celebrate the six ounces she did gain by taking a short walk around the block. We would take this private time to focus on the future,discussing what she wanted for herself. This was how I got her to focus on living another day. When she met her goal we really celebrated. I kept two plastic champagne party cup in the nurses station and we would toast her triumph with Perrier water, her favorite.

The use of visualization worked well at times. I would assist Lisa by aiding her with progressive relation techniques and then have her visualize her body as healthy again. She would tell me later that during those sessions she could feel her physical and emotional energies recharging themselves. Because Lisa found this technique to be useful, I continue to use it with all my anorexic patients.

During Lisa’s illness her parents were fighting two battles – the anorexia and their insurance company. The treatment of anorexia is a long and expensive one. Their insurance company threatened to cut off paying for Lisa’s care. I went to the hospital’s utilization review coordinator to see what the insurance companies target in the nursing notes that would determine the status of a claim. These are points I address in all my care plans. This points assure good patient care, and help patients and their family members when dealing with their insurance company. All entries must show in a measurable way the success or failure of the patient’s treatment. Calorie counts and daily weights are done accurately and documented. Any quotes the patient gives during therapy can be important especially if the patient is depressed and suicidal. Monitoring the patients medical condition including vitals every shift, intake and output, observe for signs of infection, and for any signs of stress fractures or organ failure. All patient and family teaching done must be documented in detail.

I was Lisa’s nurse, but she was my teacher. I keep her alive in my heart by using what I learned from her to help others.

Give Me That Old Time Rock And Roll

26 Sep 2006

I’ll give that song a ninety-five; it has a good beat and it’s easy to dance to.

When I was a girl growing up in Iowa, I remember watching American Bandstand with my mom every Saturday morning. We would watch the show on our small screen, black and white TV, and Mom would adjust the rabbit ears on the antenna as I danced around the living room in my bare feet. Mom and I listened to the music and critiqued the latest fashion trends. We both loved poodle skirts. I remember my favorite song was something about a one-eye-one-horn-flying-purple people eater. Yes, really! As the years passed the music changed, and I now have a long list of music favorites. I’ve been tagged, and these are my seven favorite songs.

Angel: by Sarah McLachlan. Don’t ask me why I like a song that makes me cry. Even nasty Simon Cowell loves this song.

Just to be Loved: by Al Jarreau. Listening to smooth jazz while sipping a glass of wine. It’s heaven.

Peacekeeper: by Fleetwood Mac. This is the best anti-war song recorded since Woodstock.

Imagine: by John Lennon. World Peace.

Sad, Sad, Sad: by the Rolling Stones. I like it because it’s loud, loud, loud!

Simply Irresistible: by Robert Palmer. Cool clone chicks.

Bolero: by Maurice Ravel.
Do I really need to explain this one?

Scapel, you’re tagged and so is anyone else who wants to play:-)

An Old Dog Learning New Tricks

24 Sep 2006

I just started learning about blogs a few months ago, and I’m still learning new things about the blogosphere everyday. Emergiblog is one of my all time favorite nurse blogs, and I want my sidebar to look like emergiblog’s, but I don’t know what to do. Where do all those cute little icons like “My Yahoo” and “newsgator” come from? And what is a RSS feed and how do blogs get hooked up to them? How do you increase traffic on your blog? In a modified version of Dr. McCoy’s famous Star Trek quote, “I’m a nurse, not a computer geek.”

Is there anyone out there willing to help an old dog err… nurse learn some new tricks about blogging?

Here Comes the Bride

22 Sep 2006

There’s a tradition on every nurses station when a nurse gets engaged. You know the drill, the bride-to-be prances into the nurses station and whips out her hand, revealing her engagement ring. Then, with great fanfare, everyone at the nurses station starts jumping up and down, and squealing with delight. Soon after, there’s a stack of wedding magazines spread around the nurses station as preparations for the big day begin.

After watching this tradition for many years, I’ve learned a bride must possess three qualities when planning a modern wedding: she must be organized, have nerves of steel, and very deep pockets. But thanks to Vera Wang, a popular wedding gown designer, planning a wedding is now easy. Wang not only designs stunning wedding gowns with equally stunning price tags, she has a full line of wedding products to meet your every need.

To make planning easier, Wang sells her own line of china, crystal, flatware, footwear, lingerie, cosmetics and perfume, and jewelry. Needless to say, none of this stuff is sold at Ikea, so you can expect to go broke if you buy Wang’s products. And remember, no wedding is complete without an expensive honeymoon, and for $4,000 a night, the happy couple can stay in the Vera Wang suite at the Halekulani resort in Waikiki, Hawaii.

Every time I see a stack of wedding magazines in the nurses station, I toss a Home Depot catalog on top of the pile, and tell the bride-to-be that if she picks out a ladder, I’ll buy it for her so she can elope. So far, no one has taken me up on my offer. Maybe they would if Vera Wang designed hardware.

Nurse Ratched

There has been a lot of chatter in the blogosphere about medical bloggers and HIPAA regulations so let me make this very clear: I write composite stories about many different people that I've cared for over the years.

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Amanda Trujillo, MSN, RN, DNSc-NP(s) Media & Blogger Coverage