As the title of this post may suggest I am having a love hate relationship with technology this week. However, I learned long ago I better get with the program or I would be left far far behind in every aspect of nursing. Technology is a fast growing, rapidly essential part of everyone's nursing practice. From learning to take a blood pressure with the touchscreen monitor at the bedside (first you have to set the right profile, know the right buttons to press, being able to trouble shoot - you get the idea!) to the ipad applications that are just there for those in the health care profession. Yes, yes I know these tools are there to make my job easier and promote high quality of nursing care, but instead of getting a BSN there are some days I wish I had a degree in computer science!
The online class I teach has just changed it learning environment from EPIC to Blackboard. Now I had just come to terms with EPIC, me and EPIC had recently become friends, I was able to join the discussion board, use the grade book, send and receive emails all without too much stress. Now my new love is Blackboard but we are like a dysfunctional couple from the "Bachelor", we desperately want to make it work but we do not really know each other yet, and we are in love with the thought of being together but the reality.....well it leaves me wanting. Learning a whole new system has seriously slowed down my productivity and increased my stress this week.
The University I am a clinical instructor for recently changed their email server from Outlook to Google.....What!!!! What was wrong with Outlook, it was an old friend, like sleeping in your favorite t-shirt. This Google thing is for the millennials, how do I populate my address book,why am I now getting emails from the whole university not just the nursing department. I am not really interested in who is running for freshman student government (although I am sure it is extremely valid), but now I am getting daily emails from Tiffany, Justin and Dave trying to persuade me why they need my vote!!!
Now don't get me wrong, I am a lover of technology. In our house we have more computers than TVs, sad fact is you will often find my husband and myself in the evening working on our laptops and ipads spontaneously. I pride myself on being a multi tasker, I can cook dinner and text my kids with one hand behind my back. But sometimes technology goes so fast I feel stressed, marooned with nowhere to go. Thank goodness I have very techy children who are also nocturnal so I can call them at anytime of the night. Goodness knows how I would have got through grad school without Elliot showing me how to use PowerPoint.
And it got me thinking, nursing is one of those multi generational professions. We have nurses in their 60's and their 20's who must both coexist with peace in the clinical environment. And technology can make it hard for those who have not been exposed to it all their lives and fear looking stupid if they ask for help too many times. In the converse, the older more mastered nurses often do not tolerate the millenials with the insane ability of opposable thumbs and the ability to listen to you while playing on their smart phone! There must be tolerance both ways because I am afraid my friends that accelerated technology is here to stay.
All I can say is HELP!!!!!
Thursday, September 27, 2012
Wednesday, September 19, 2012
Nurse Leadership
I have just come to the end of teaching an online class on nurse leadership, it is a class I have done a few times now and its good to deal with a familiar syllabus and understand upcoming assignments better. The course content has stirred in my thoughts about nurse leadership and a discussion with students that is new and energizing.
I look back at the nurse leaders I have been fortunate enough to work with and I learned something from all of them, the good ones as well as the bad! I have had leaders who have had a transformational democratic style and those who were undoubtedly autocratic dictators!! I remember one of my first student nurse clinical experiences on a surgical unit in a small mining town in Northern England. The matron on the floor had trained in the military..enough said, you could eat off her floors. She ran her floor like a D Day reenactment! It was intimidating, we asked very few questions but somehow learning took place and the patients were cared for beautifully. I do not remember one post op surgical infection, no-one went a day and a half without pooping! and those beds were made with crisp sharp angles on the corners! But I also took from that experience I did not want to be an intimidating leader, I wanted relationship, to be a mentor, more of a coach and that is what I have based my hands on and teaching career on in nursing. I also remember my first job as a graduate nurse on a busy Neuro Ward in Oxford, England. The matron had an open door policy, wanted to know all her staff and their husbands, wives and children. We socialized outside of work, it felt like family, community. It was a gift as a new nurse to be able to make mistakes in a safe and supported place, I learned so much and still think back on that time with fondness.
The syllabus for this leadership class also presents the students with a survey of how politically savvy are they. Very valuable tool, are they connected to the staff as a community or do they operate in an isolated way? Is their voice influential and is their leadership style appropriate for the environment or do they need to consider changing it? This survey led to much class room discussion on who we are, why we are the way we are, and what is the cost benefit/loss of all of it. To be influential, powerful and effective as a leader I do not think you have to have the loudest voice, strongest personality or the most letters after your name, although I do think education gives you greater credibility. But I do think you must be authentic, have incredibly high standards of nursing care, treat patients, colleagues of every color, rank and skill with respect and keep working on growing professionally and personally.
I look back at the nurse leaders I have been fortunate enough to work with and I learned something from all of them, the good ones as well as the bad! I have had leaders who have had a transformational democratic style and those who were undoubtedly autocratic dictators!! I remember one of my first student nurse clinical experiences on a surgical unit in a small mining town in Northern England. The matron on the floor had trained in the military..enough said, you could eat off her floors. She ran her floor like a D Day reenactment! It was intimidating, we asked very few questions but somehow learning took place and the patients were cared for beautifully. I do not remember one post op surgical infection, no-one went a day and a half without pooping! and those beds were made with crisp sharp angles on the corners! But I also took from that experience I did not want to be an intimidating leader, I wanted relationship, to be a mentor, more of a coach and that is what I have based my hands on and teaching career on in nursing. I also remember my first job as a graduate nurse on a busy Neuro Ward in Oxford, England. The matron had an open door policy, wanted to know all her staff and their husbands, wives and children. We socialized outside of work, it felt like family, community. It was a gift as a new nurse to be able to make mistakes in a safe and supported place, I learned so much and still think back on that time with fondness.
The syllabus for this leadership class also presents the students with a survey of how politically savvy are they. Very valuable tool, are they connected to the staff as a community or do they operate in an isolated way? Is their voice influential and is their leadership style appropriate for the environment or do they need to consider changing it? This survey led to much class room discussion on who we are, why we are the way we are, and what is the cost benefit/loss of all of it. To be influential, powerful and effective as a leader I do not think you have to have the loudest voice, strongest personality or the most letters after your name, although I do think education gives you greater credibility. But I do think you must be authentic, have incredibly high standards of nursing care, treat patients, colleagues of every color, rank and skill with respect and keep working on growing professionally and personally.
Tuesday, September 11, 2012
Yet Another Nursing Dilemma
Of course as nurses we often have daily dilemma's because caring for people can be messy, does not always fit into any ethically correct template, all those variables of people, family, diagnosis, living arrangements, emotional state, motivation or lack of it play into the outcomes of the nursing plan I devise at admission.
I have this patient, lets call her Alice, she lives with her mentally challenged brother who is high functioning but certainly not capable of making any of the household decisions. Alice has COPD caused undoubtedly from her addiction to cigarettes. She is admitted to the hospital on average once a month due to an exacerbation of COPD, is on 6 liters of O2, still smokes at least a pack a day. Alice has type 2 diabetes caused undoubtedly from extended use of steroids for her COPD and an addiction to fast food, she is low income and so I have organized meals on wheels to be delivered every week, she is completely home bound so I also organized a food pantry to deliver to her every week. She orders out fast food to be delivered daily. The end of the money always comes way before the end of the month. She cries and cries by the 20th of every month that she has no funds to feed her or her brother even though the fridge and freezer is full of donated food she does not want to eat. She is estranged from most of her family due to her unhealthy lifestyle, they are all exhausted with trying to help her, so Alice is basically alone with her brother.
Alice has pulse ox consistently in the high 80's on O2 and her blood sugars are regularly over 250 in the morning if she takes them at all. There are many other diagnosis including colitis, depression, fibromyalgia, cataracts to name but a few. She sees her physician monthly (when she is not in hospital) but he has all but given up on her because she never follows instructions.
For the past 18 months I have been seeing Alice, twice sometimes three times a week to monitor her physical status and teach/encourage her on smoking cessation strategies, compliance with a diabetic diet, and most of all O2 safety in the home (I am so afraid she will blow up her and her brother when smoking during O2 use). Nothing has changed, if anything her physical condition gets progressively worse. And in the midst of all this, we became friends, I like Alice, she likes me. We start and end our visits with a hug. She has my cell phone number memorized (not always a good thing!). And so I continued to go and attend to her needs, and I know her physical therapist was working as hard as I was to help Alice reach her potential, all to no avail. This week I realized I had become another one of her enablers. It would have been easier if Alice were obnoxious, verbally aggressive but she is not, she is sweet and grateful and has no interest in participating in her plan of care. I am no longer helping her in anyway. So after a case conference with the team and her family doctor this will be the last week I will see Alice.
Tuesday, September 4, 2012
Summer.....what Summer
So great plans and all that. My summer was supposed to be quiet and serene, lots of time for getting through that pile of books in my study and do some writing, including updating this blog on a weekly basis. What happened? Life happened. We spent the beginning and the end of the summer travelling to Barcelona, London, and later South Carolina and Colorado and thoroughly enjoyed all of it, especially Colorado, there is something about being in the mountains that speaks to my soul, restores me a little, we all need that every now and again, especially in a high burnout profession like Nursing.
I continued with community nursing which had its very busy weeks covering for staff who were gone on vacation. I had both interesting, sweet and challenging patients and some very hostile relatives. I continually tell myself, their aggression is not really about me, its more about the frustration of their situation. For an elderly patient who is facing end of life issues, a helpless relative can feel powerless and this can come across as dissatisfaction of care to the health professional in the line of fire (literally!). Even though I know all this after several "not so nice" rels this summer I admit to it all getting a little old, being shouted at and second guessed several times a week. But we soldier on, the hands on care is still the most magical part of nursing for me.
I also continued with my online teaching commitments. This summer I have been coaching a leadership class and thoroughly enjoying it. These young BSN students see themselves as novices even though many of them have years of clinical experience. But the online education experience is a wonderful medium to exchange powerful ideas, lively discussions, solve issues hypothetically through PowerPoint presentations and develop a base knowledge that will hopefully lead them onto successful leadership positions. All I really have to do is facilitate and grade 60 papers every weekend (groan!), all done at home by the power of my laptop, my perfect kind of job.
Just when things got to August and looked like I may have a month of breathing space before my semester starts again for my traditional teaching job at a Philadelphia University we met this guy....
I really was uncertain about doing the dog thing after losing our beloved Golden Retriever in April. However one particular weekend when I was missing him so acutely my husband put me in the car and took me to a pet adoption at a local pet store....and there we met Toby. It was love at first sight. An adorable choc lab/pointer mix. Loves to snuggle, chew cell phones and TV remotes. He is especially fond of the 3am pee followed by a snuggle in bed. And so I am now walking the neighborhood at 7am/pm every day, chasing him around the house with my carpet shampooer (forgot how much work potty training is), trying to persuade him not to eat the cat daily ( I secretly think the cat quite enjoys it!). Exhausted and enjoying every minute of him
Faculty meetings have begun, planning and organizing a new semester is ongoing, I am ready to roll with whatever fall brings me and looking forward to it.
How was your summer?
I continued with community nursing which had its very busy weeks covering for staff who were gone on vacation. I had both interesting, sweet and challenging patients and some very hostile relatives. I continually tell myself, their aggression is not really about me, its more about the frustration of their situation. For an elderly patient who is facing end of life issues, a helpless relative can feel powerless and this can come across as dissatisfaction of care to the health professional in the line of fire (literally!). Even though I know all this after several "not so nice" rels this summer I admit to it all getting a little old, being shouted at and second guessed several times a week. But we soldier on, the hands on care is still the most magical part of nursing for me.
I also continued with my online teaching commitments. This summer I have been coaching a leadership class and thoroughly enjoying it. These young BSN students see themselves as novices even though many of them have years of clinical experience. But the online education experience is a wonderful medium to exchange powerful ideas, lively discussions, solve issues hypothetically through PowerPoint presentations and develop a base knowledge that will hopefully lead them onto successful leadership positions. All I really have to do is facilitate and grade 60 papers every weekend (groan!), all done at home by the power of my laptop, my perfect kind of job.
Just when things got to August and looked like I may have a month of breathing space before my semester starts again for my traditional teaching job at a Philadelphia University we met this guy....
I really was uncertain about doing the dog thing after losing our beloved Golden Retriever in April. However one particular weekend when I was missing him so acutely my husband put me in the car and took me to a pet adoption at a local pet store....and there we met Toby. It was love at first sight. An adorable choc lab/pointer mix. Loves to snuggle, chew cell phones and TV remotes. He is especially fond of the 3am pee followed by a snuggle in bed. And so I am now walking the neighborhood at 7am/pm every day, chasing him around the house with my carpet shampooer (forgot how much work potty training is), trying to persuade him not to eat the cat daily ( I secretly think the cat quite enjoys it!). Exhausted and enjoying every minute of him
Faculty meetings have begun, planning and organizing a new semester is ongoing, I am ready to roll with whatever fall brings me and looking forward to it.
How was your summer?
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