Nurse Simulation Time

We are at that point in the Semester where we retreat from the clinical area, head back to the University to do Simulation

Nurse Simulation is where we take the students into the lab and have a computer powered and controlled baby that we can create different scenarios for the students to practice different events.
Two groups over two day, each group was split into two (because of size) and so I did simulation 4 times....I'm a bit simmed out but it was a very good experience

The scenario we set up for the students was a 24 month old baby with previous diagnosis of asthma who came in wheezing.  They had to manage the care and depending on how they were doing we manipulated the situation to drop the pulse ox levels, increase the pulse, creating stress and see how the students reacted.

The cons of this experience has to be it is not real, and so some students may not take it seriously.  However, the pros far outweigh the cons.  In the clinical environment it is very difficult for me to "schedule" and emergency event.  In simulation we can create an event for the student and they can manage it in a safe environment, i.e. no-one dies.....always a good thing!!!

It was interesting to see how my students reacted, all the groups had some issues and one group very nearly killed the poor child as they did not notice the pulse ox had dropped to the low 80's and the pulse had risen to above 200!!!  They were so focused on their tasks they failed to see the big picture but what a great learning experience this was when we watched the video in debrief (yes, we taped them!)

One student froze, was literally paralyzed when things started to go downhill, another student reacted to this by yelling at her!!  These are all real life events that happen in the clinical area so we were able to talk about how people react to stress and how you can develop your own personal strategy to be both effective and safe.

A good day, we all had a bit of a giggle viewing the tape afterwards but a wonderful learning experience for all.

Pediatric Palliative Care

Do you think there can be such a thing as a beautiful death?
Do you think there can be such a thing as a beautiful pediatric death?

These are questions that we do not normally discuss, even in nursing arenas but it needs to be discussed more.  We are very uncomfortable with talking about end of life issues, but you know what they say, the only two things that are certain are death and taxes.  It is a sad sad world where children die, but as tragic as that is, it still happens and I do believe we can orchestrate such a thing as a beautiful death for a family, if possible. 

 There are those situations due to trauma, accidental or non-accidental that there may be no time to prepare all concerned but there is certainly lots of follow up that can be done to help with the grieving process.

Yesterday in clinical I took my students to a brilliant lecture by the head of the Palliative Care Team at the hospital where I teach.  She spoke bravely but simply, challenging my students to examine how they felt about these difficult issues.  Some of the questions she asked.

• What is your attitude to death?
• What is your attitude to a child's death?
• What is your own experience with close family death?

The answers to these questions is the beginning of an attitude to end of life issues, and eventually you wear your attitude on the outside, don't you think?

It helps tremendously to be a part of a healthy team, where up:down communication freely flows, where you have an ability to debrief, to say you need a break without recriminations, where you have wonderful collaborative care with the family, physicians, pastor, rabbi whoever, child life, the patient (duh obvious!...not always).  It also helps if you have a dedicated palliative care team aimed at the population you are working with, even better if there is a pediatric hospice in and out patient facility with endless resources for these families.  

It can be unusual for all or any of these components to be present and as a result we are doing our children and families a huge disservice because at all costs I DO think we have an obligation to create a beautiful end of life experience for the child if we possibly can.

Our speaker ended with strong words about taking care of ourselves as nurses so we can be the best we can be, this seems to be a theme this semester and I am so glad my students are hearing it over and over again.  It does not work to run yourself into the ground emotionally and physically, nobody wins, least of all you!

Think I got my second wind this week, inspired by my students, the children we are seeing in the clinical area and the richness of the professionals I am coming across.

I think I can make it til Thanksgiving!!!!!

Mid Semester Exhaustion And How To Conquer It

What, exhausted already, its only the middle of October.  I have to keep going until beyond Thanksgiving.  I seem to be making heavy weather of this semester and I am wondering why but I am determined not to let it affect my standard of teaching.  From one who has gone through extensive education and know how expensive it is, I am determined to give my consumer (the student) the best possible product.  So I try to engage with every student on an individual level and group level. 

This past week in Pediatric Clinicals the Hospital Chaplain came to speak to us in post conference.  He surprised (and impressed) me by talking as much about taking care of ourselves as nurses as how he cares for the families he comes across daily.  He encouraged us all to ground ourselves in a belief system, whether that be Christian, Muslim, Atheistic or whatever, but ground yourself there and find your stress reliever without self medicating on the unhealthy things like alcohol, recreational drugs and prescription drugs ( a huge problem amongst health care professionals right now).  He encouraged us to find that one trusted person to talk to and not to have an ego that keeps you silent, a burden shared and all that.......

I see the pressure all my students are under in Nursing School, the classes, the clinical days, the projects, the exams.....those dam exams that count so much toward the final grade.  And last week especially I felt like everyone was in a mid-semester hump.  I am honest with them about my desire, no need to see a continued high performance but I do cut them a break any way I can and hope I can be that trusted person to talk to.  A couple of them have really sad stories and I have to stop myself from bundling them up in my car and taking them home with me to "nurse" them through nursing school......really done it before.  But really here is some serious advice on how to survive the semester, I need to do this myself as well as advise it to my students.

Keep a routine. Keeping a schedule can help students tackle one hurdle at a time, and as a result, feel more in control. Get a schedule from a supply store or make one yourself and hang it up in your room. Write down everything you need to do in order not to miss things out.

Get enough sleep. Students should at least sleep 7 to 8 hours a day to make it easier for them to cope with stressful situations. Students will also be less irritable and tense.

Exercise regularly. Exercising at least 30 minutes a day can help alleviate stress, tension, and boost confidence. Get on the treadmill, run a mile, lift some weights.

Try to relax. Listen to relaxing music, take a long bath, watch a romantic movie or meditate. Relaxing for at least an hour per day can help you get rid of that stress building up inside.

Have fun. Take a step back and remember to have fun with friends. It can be helpful to have a group study session. It will be entertaining and instructional at the same time.

Stay calm. Do not rush yourself and then start to panic. This will only add to your stress level. Just take it slow and be steady. Take deep breathes! Breathing will physically and emotionally relax your body.

(taken from http://www.wikihow.com/Cope-With-Stress-at-School)

Moving To Computerized Charting

The hospital where I teach pediatric clinicals has recently made the transition to computerized charting.  Everyone held their breath during the preparation time and now it seems people are learning to use the system, kicking and screaming if they like it or not.  Nursing informatics is here to stay and so we had all better get on board.  However, watching from a slight distance and having no bias one way or the other to the outcome of this huge project I have made some interesting observations.

There seem to be many pros and cons to computerized vs paper charting.  The first biggie is the sheer size of implementing a project like this.  The training goes on and on and on to every single member of the team.  There is a sharp learning curve that creates momentary frustration and in the meantime, the nurse especially, is not spending as much time at the bedside.  When I walk on the floor early in the morning gone are the days when the staff are chatting with each other, now they are glued to individual computers on wheels, catching up on their documentations and trying to figure out what the heck all those icons mean.  I also have noticed that when the nurse enters a room to conduct an admission she now takes her trusty new BFF (said computer on wheels) with him/her and stares at that while feverishly inputting data and the family do not get much of a glance.

Having said that it is a huge bonus to be able to now read the chart with legible handwriting and not to be wasting mounds and mounds of paper that previously had to be securely shredded!  It is also worthy of note that the new system has automated reminders, which has to help decrease the incidence of medical errors.

A patients status can be updated quickly and all who are involved in the care can see that status promptly, this can only help improve cross-team communication.  

However, approaching week 5 of the semester, despite lots of training, begging and weeping I still have to receive access to computerized charting and then it will be in Read Only Status!  As a result me and my students have been conducting clinicals pretty much blindfolded having very limited access to the patient chart.  The students also have no opportunity to do any charting which I think is a huge loss for their clinical experience.

Am I a fan of transitioning to computerized charting?  I think inevitable I am, but it has many many teething problems in the meantime.

New Semester. New Students. New Challenges New Season

Its already October and I have been guilty of some serious blog neglect.  I feel like I lost September to new semester business, traveling and a nasty bout of pneumonia (apparently I am not superwoman!!)

However, now into the first few weeks of the semester I feel like I a hitting my stride and for the first time since August feel somewhat on top of things in terms of class prep and grading.  My Monday and Thursday pediatric clinical classes are in full swing and going really well.  Face to face teaching with students is really my favorite.  Especially when I have students who are likable, communicate well and are eager to learn.  Yet again I have groups that represent the United Nations very well, I think the school assumes that because I am a foreign nurse I can cope with these non-native speaking students, and to be honest I do not hate it but it does pose its own challenges.  I have students this semester from Haiti, Liberia, The Ivory Coast, Jamaica and its not so much the language that is the issue, they all have mastered the English language really well, but culturally there is a little disconnect.  I can only imagine what assumptions and faux pas I would be making if I was nursing in their country, so open and honest communication without judgement is key.  We are all learning together which is essential and fun.  Cold season is beginning with a vengeance so we have had our fair share of bronchiolitis and RSV so far, lots of babies.  These are good cases for mastering that first basic assessment.  So far so good.....we did not kill anyone yet.....always a good thing!!!!

Online teaching this semester I am focusing on 120 students in one class. My life was just that crazy I could not face bopping around with several different syllabi's, this class is the intro in the RN-BSN course.  It is where students orientate to the online learning environment, start to learn about APA and posting assignments.  However, we have had some very interesting assignments this week including writing a letter to your local legislator regarding an issue in your own clinical environment that is of concern.  Lots of great topics including violence in the ER, the cost of safety with the nursing shortage, how to make the transition from RN -BSN and better one for all.  All huge topics that are worthy of being visited in discussion and with more funding.

I love love love this time of year, although I am still waiting for it to cool down some, we are having a burst of heat here in the Northeast.  But October means its nearly November and that means my kids will almost be home for Thanksgiving.  The test kitchen already started in my house!!!!  Bring it on, cool weather, crisp mornings, sweaters and colorful scarves, evening fires, feeling blessed.

Nurses and Anxiety

While driving home from the grocery store on Sunday ( I know, I know my life is just that exciting).  I was listening to NPR and this show came on that had me so gripped I actually stopped in the driveway of my house to listen to the end of it and had to text my husband to come and get all the cold and frozen stuff out of the car because I could not move (I really did this....and he was really thrilled!).  The show was given by an Emergency Room Chief Attending who reports how he was the perfect student, aced everything, memorized everything and was going to be the best physician ever until....he made a mistake.  He sent an elderly woman home from the ER in acute congestive heart failure because he missed it, he was not perfect.  Two hours later the family rushed the woman back where she died in the ER. 

 This began a quest for this physician to not only face his own imperfection to find other physicians that had made mistakes too.  He found that not only did physicians not want to admit they made any kind of mistakes they did not want to talk about it as it was anxiety producing.  This anxiety led to a decrease in performance, increase in stress,  and a false culture in their profession that all is well.  Physicians have a reputation of closing ranks around each other when a mistake is made leading to sometimes never getting to the real story...but more importantly those involved and colleagues around them from learning from an important teachable moment.  Now this physician runs meetings where mistakes are openly talked about  so everyone can support each other and more importantly learn from it, be honest and support each other.

Several of the nursing students, who I love and adore, are entering their final semester of nursing school.  I stay in touch with many of these students on Face Book and their stress at facing their last semester, passing finals, onto the NCLEX and finding a job has sent their stress off the scale.  I could feel it and see it from their Face Book posts and the panicked multiple texts I was getting.  I realized this stress and anxiety was at worse going to hold back these hugely talented future nurses and at best deny them from really enjoying their final semester of nursing school.  This is not OK.  In Nurse Education we are very good at setting objectives, measuring academic progress through testing, evaluating clinical skills, benchmarks, case studies, computer generated tests over and over to give a normal person carpal tunnel syndrome.

So the first week of October we are starting a NCLEX review/support group at Angie's house.  All my students are invited, no-one will be denied.  There is no cost for this but you have to bring your A game and a good attitude ( I have a really low tolerance for whining!)  The session will start with 30 minutes of yoga, continue with lots of review and end with tea and cake and sympathy (it is a British house after all).  We are teaching these future nurses how to care for their patients and their families.  We must not forget to teach them how to care for each other and most importantly how to care for themselves. 

Back From Vacation

I'm back.  Hope you had a great summer.  I cannot believe that summer is almost over but for me I am afraid it is.  This week was the start of faculty meetings at the Philadelphia university I teach at, and I am well into 2....yes 2 online classes that are lots of fun but proving quite time consuming.

One of the classes I have taught before, its a Community Health class which is one of my nursing passions.  I know the syllabus quite well by now and its fun to be back, have not been involved in this class for a few months.  The other class is called The Professional Nurse.  It is the very first class that online students take and is a means of orientating them to the online world, sending them on scavenger hunts to access the library, put references in the APA correct way (I always found this a curse until I found a very handy dandy online tool to help me!).  Anyhoo these students need a fair amount of hand holding, I remember well my first online class and how stressful it was. It has kept me occupied

But back to Summer.  It had to be one of the best summers I have had in many many years.  For the first time in living memory I worked from home and loved every minute of it.  Another advantage of being my own boss, I am always employee of the month!  My boss (me) gives me days or hours off whenever I want.  One look from Toby and we were out the door running around the reservoir.  It was a stress free, wonderful 4 months.

However, I feel ready to get back to a routine of teaching outside the house, continuing with my online teaching and some other business opportunities I have been building.  One of those is building my health and fitness business. I launched a new website that has been fun to build and blog about.  Here is the link

Curves and Carrots

Pop in and enjoy, I try to blog on this site several times a week.

More to come on a weekly basis.  Its good to be back even if the days are warm and the evenings are balmy.  Toby sure loved having me around and we acquired 2 new kittens.  All I know is I have never been that much of an animal person until all the kids left for University, now I have these surrogate children.  I am going to end up being that cat lady.  One day I will be found dead in my home at a very elderly age surrounded by 15 cats and 5 dogs......perish the thought!!!

Taking A Little Break

I am in serious Summer mode and as a result seem to be having some writers block when it comes to Nurseology.  Not wanting to create a load of forced garbage I have decided to take a few weeks break and recommence this blog in September when I start my face to face teaching gig again.  Maybe by the then the creative juices will have started to flow again!

In the meantime meet me over at my other website curves and carrots which has a blog that I try to update at least four times a week.

http://www.curvesandcarrots.com/

Have a fun summer and I will see you in September

An Online Education vs Traditional Classroom Setting

As someone who has been educated as a nurse in both venues, that is, in the traditional classroom and in the online environment, and as someone who teaches in both places I thought it would be interesting to do a comparison of both mediums and see what you guys think.

I did my general nursing diploma and first post graduate nursing qualification in the classroom before the online education world ever existed (showing my age, I know!).  I enjoyed both these experiences immensely.  As a novice nurse who is a visual learner I definitely benefited from the face to face clinical experience and would recommend this form of education to anyone starting out in nursing.  The clinical and academic parts of nursing are so married together, and when you are starting out I think there is a great benefit of having a physical presence in the classroom and clinical area.  A place where you can ask questions and get feedback real time and relate it to your practice is essential in not just building your confidence but your competency.

Later on in my nursing career I attended graduate school online.  I chose the University of Phoenix to complete my MSN.  This school, I know has varied reviews but I have to say I had a fabulous experience there.  I found the quality of teaching and the sense of community extremely high.  The reason this worked for me is the same reason it works for many people.  I had a growing family and a full time job and just did not have more time in my week to "attend" class.  Working online meant I could go at my pace day or night (and I did alot of nights!!).  When you get to the graduate level, research and projects are done collaboratively in the remote setting anyways so doing it online did not seem to skip a beat.  However, the downside was when technology had a glitch, a power cut, the server being down, email platforms not working efficiently and the dreaded help desk that can be of no help at all.

Many Universities are now 'blended" in that they offer classroom and online classes, I predict this from of educating our nurses will only grow.

I love teaching face to face.  I find I can get to know my students quickly and there is nothing like that non-verbal communication to assess their strengths and areas that need to be worked on.  However, I get to know my online students also, but not in the same way or at the same depth.  When you are a student online you can develop your own online persona.  This can be a plus is you are quiet and shy in the classroom, you can have more of a voice in the online environment.....its not as intimidating.

Do you think there will be a time when we do not need the traditional classroom at all?  My personal feeling is do your BSN in the traditional setting but after that the choice is yours and it can be a very good and flexible experience if you decide to go the online route.

Patients, Families And Social Media

Last week I blogged about nurses and social media and although I stand by all I said about being very wary I realize that social media can be a great source of support and community for many nurses and as long as we respect the boundaries that it should  have all should be well in your online world.

Of course everyone has access to the Internet and that includes families and patients and this is a really really good thing and sometimes it can be really bad.  So I have separated this into the pros and cons.

PROS

• Great way for families to share news and updates without having to talk to a zillion people
• A good way to spread patient education to a wide audience very quickly
• Chat rooms and support rooms are a lifeline for many families and patients
• Patient/Family Blogs are growing and can be very therapeutic for all involved to write down what they are going through and connect with others

CONS

• There can be blurry lines when it comes to privacy, patient and families can identify other staff and patients without their consent
• There is an opportunity here for bullying of staff online if the family is not satisfied with care, it is a place for them to vent if they do not feel they can do it face to face
• When/if a staff member friends a patient or family member it can develop the relationship in a non-therapeutic way, I would strongly advise against this.
• Families who are hooked up to other blogs with patients in the same speciality/institution have an opportunity to compare treatment protocols and often bring up why they did not get this "drug" or "treatment" at a clinic visit (I have seen this happen in pediatric oncology) when there is no understanding of the need for customized care in many situations.

There is more I am sure, so much more to discuss but I do not want to make this two part blog series into series akin to War and Peace.  Its meant to get you thinking and start a conversation.  

And now.....for something completely different, here are Coco and Toby meeting a new friend (Timmy The Turtle) on our morning run.  I think they were more excited than Timmy was, he looks a little shy don't you think?

The Pitfalls of Nursing and Social Media Part 1

When I first started my nursing career we were warned never to talk about a patient and their details in an elevator or a public place.  Later on I learned about the value of a therapeutic relationship where you keep your personal information private and focus on the patients needs and don't talk about them by name after work.  Then in the States came the advent of HIPPA, where all information became protected and it was hard to even have a conversation on the phone with a colleague without the HIPPA Gods slamming on your head a $10,000 fine for infringement of privacy.

However, has nursing caught up with technology, especially in the world of social media?  I think not, as nurses we have to be so careful as not only do we put our patients privacy in jeopardy but also our jobs.  Just about everyone has a camera on their smart phone, which are also connected to twitter, facebook, instagram and other social networking sites.  Information and pictures are uploaded in real time and even if you take down a picture or a post it can live on in Internet land.  This is rocky ground for nurses who have become accustomed and enjoy the daily connection that an online community bring.  I am one of those people, now the owner of two blogs, a business website, two facebook pages, a daily instagram habit I consider myself pretty connected, it fills a need and builds my business and it has been a wonderful addition to my daily life.  This is not a commentary on why social media is bad, it is a caution on how are frequent and unedited posting habits can detrimentally affect the lives of our patients and our livelihoods. We need to have a filter people, a very strong one! 

It is common place to post about a bad day, a good day, a difficult experience but you cannot have any patient or institutional content in there that may be traced back to an individual or place of employment.  Taking pictures of patients and posting them, especially children is a huge no-no, they cannot give consent, its unfair to ask them and your employer will be hopping mad if they find out.

I recently posted a couple of pictures of my students at the end of semester in the clinical environment and I am double thinking that move.  As a person who has a position of authority over my students it was probably unfair to take and post picture of them as it is difficult for them to decline (who wants to tick off the person who is writing your evaluation even if you have a good perceived relationship with them).

So, after doing some research on nurses and social media I am rethinking my personal code of ethics on the whole thing and will emphasize much stronger with my students what they can and cannot do regarding their clinical experience and social media, and unfortunately there is a whole lot more cannot than can.

Undoubtedly we need more education for employers and employees on this issue.  We need support and not blame but all health care professionals need to know the consequences if we stray.

There is so much to say on this topic and I could go on and on but then I would bore you (maybe more than you are already) so lets talk about this again.......next week!

Friends At Work: Blessing or a Curse

I am in abit of a dilemma about friendships at work especially in the high stress environment of nursing.  I have had close friends at work which have really helped in those I-just-cant-do-this-one-more-day moments who have kept me sane, given me a shoulder to cry on and laugh with.  I have enjoyed the camaraderie that these relationships bring, the feeling of support and that somebody has my back.  But when those friendships teeter a little being at work with someone who knows so much information about you can make you feel vulnerable, it can be hard to deal with those moody days when you are not getting on so well, and that got-my-back can sometimes morph into someone is going to stab me in the back!!! And we all know that in nursing there are some events that happen at work that quickly bring the best and the worst out in us!

My very first nursing job as a Staff Nurse on a demanding Neurology Ward in Oxford, England I met a wonderful lady called Carol who became my mentor before I even knew what the word mentor meant!!  This was a deep friendship that still sustains today and I would not have survived my first couple of years of nursing without her.

Then I have had friends outside of work who are also nurses and there is immediately an instant connection, nurses can always chat.  Early on I met an amazing girl called Karen, we became very very close, worked in the same hospital but never really with each other, but had enough connection that we both supported each other, especially when we had our first babies.  Again, another friendship that was as necessary as oxygen at that time in my life.

Then there were the new jobs where I undoubtedly tried too hard to connect in an effort to fit in.  The danger with close friendships at work is sometimes you can divulge too much information about your personal life too soon and when that friendship starts to "crumble" it becomes toxic and your hostile friend can now use all that "stuff" against you.

As a seasoned nurse I now advise my nursing students to be professional, always always have your colleagues back, you never know when you want them to have yours!  If seeing colleagues outside of work and getting close is what you want/need go ahead, but be aware there can be pitfalls, Big ones!  If you are not that kind of person, its really fine to have good communication at work, for people to know just enough about you and then leave the job at work, colleagues and all when you leave.

I would be interested to know what you guys think.  What is your experience of friends at work?  The good the bad and the ugly.

Graduations And Celebrations

My eldest son just graduated this weekend from the University of New Hampshire with a degree in Information Technology.  It has been a journey for him, did a 4 year degree program in 5 years, yes there were some bumps along the way but Joe is the epitome of tenacity and determination and his Senior Year he killed school and got himself an awesome internship.  They must have liked/loved him as they just offered him an amazing full time job with benefits and a future.  Can you say now-you-can-pay-your-own-cellphone-and-car-insurance!!!!


I have also been teaching long enough to start seeing many of my students (who are juniors when I get them) graduate and get their first Nursing jobs.  Its a time of new beginnings and celebrations.  There are lots of cliches out there about life being a journey not the destination, its not the number of breaths you take but how you breathe etc etc, but seeing my son and my students graduate and move onto the next part of their lives got me a little reflective.  

Growing up as a young millennial pursuing a professional life is a huge challenge in 2013 and beyond.  I worry did I prepare my kids enough, do they know how to balance a check book, get in and out of a relationship!, have a good work ethic, be an advocate for themselves and others?

Nursing is a lot like life, you need good people skills, a thick skin and a strong stomach!  You need excellent communication skills especially with those who have none!!  You need to be flexible and change direction on a dime but investing in these young people is a joy that is becoming a large part of my professional life.  We need to be tolerant of each other, especially the generational differences, no style is wrong, it's just different, strengths and weaknesses in both.  It took us a great deal to get our kids through University, both emotionally, physically ( I hate hate moving kids in and out of a dorm!) and fiscally, but I would do it all again, with these kids (Joe, Elliot and Katie) and work three times as hard to make sure they had this experience at this point in their lives.  Only one more kid to go, we are down to counting semesters, only 3 more semesters for Elliot in Boston and then he too can pay for his own rent, cell phone and car insurance........then what will I do with myself, probably find another young adult project.   

Enormously proud, hugely happy!

With my sweet boy, Joe, we are so proud of him

Then it's time to party, we had an amazing evening with Joe and his friends

Knowing Better.....Being Better

 

8 Ways to Become a Better Nurse

Have struggled this week to come up with some ideas for my blog and was kind of down on myself that because I am not doing active bedside nursing right now really I am not a real nurse and have no right to blog about the subject.   Nothing could be further from the truth.  Nurses are more than clinicians in the practical sense and we use nursing in all of our life skills be that teaching, family, executive function, friendships.  Anyways on doing some research I came across this blog entry by Phil Baumann who validated my point that even those of us who are not currently bedside nurses still have a voice and an opinion to put forth.  I know that at the end of every class I teach, every semester, every patient case that is closed I ask myself what did I do well but what could I do better.  In the business of our lives its important to reflect every now and again.



Guest Phil Baumann shares some great advice on how to be nurses can improve their care.

This is a guest post written by Phil Baumann originally posted on his website.

One of the benefits of being away from bedside nursing is that I’ve had time to reflect on my own performance. How could I have been better? What simple precepts would have helped? Being out of the “fog of war” has given me a clearer view of what’s right and what’s wrong in health care. Our culture doesn’t offer much positive encouragement for the nursing profession. That’s a costly shame, as many Baby Boomers soon will discover. To help out, I’ve come up with eight ways to become a better nurse.

1. Pay attention to how you perceive your patients
2. Intend nothing but the best for your patients
3. Speak the truth in a way that echoes your wisdom, not your darkness
4. Act on the facts but respect your intuition
5. Live your life as a connection to something greater than yourself
6. Work through your hardest times, not against them
7. Mind your mind: its power to destroy is its power to heal
8. Focus on the moment, not the past
9. Some of us are cut for bedside nursing, some of us aren’t. I think if you’re in bedside nursing and enjoy what you do then you’re a Jedi Knight who commands more respect than you probably receive.

For those of you who don’t quite enjoy what you do, think about your reasons for what you do. Consider the eight precepts (or make up your own) and see if anything changes for the better. You have more options than you realize.
Feel free to add your own suggestions for becoming a better nurse. If I get to 101, I’ll post your thoughts here and promote the living shit out of the list.
I hope the list I’m offering here helps you to become a better nurse, a better person, a better part of our quickly-changing world.

Thanks Phil........well said!

I'M BACK!!!!!!

So after a bit of a break in my posting due to a technical issues (was locked out of my Blog) I found a college kid (Sam Faulkner you rock!!) who is helping me with a new business website and got me back into Nurseology.  This makes me immensely happy, all I have to do is feed him (college kids love to eat) pay him a small hourly fee and he fixes all my IT issues.  Money well spent and he is available for hire locally or remotely so if you have a need, message me and I will give you his details.

Anywhoo, back to the plot.  Wow I have a whole year-to-date to talk about.  Where to start?  So I took a hiatus from Visiting Nursing this year as I have so many other projects on the go.  I miss the hands on clinical experience, I miss the one on one patient contact and the relationships that I made in the field.  I do not miss being a slave to the schedule, traffic jams, showing up at someones house when you have just told them (10 minutes ago) you are on your way and they have either gone out or will not let you in.  I do not miss being yelled at by family members because I cannot fix their loved one who is in the stage of end-of-life.  I do not miss working with a dysfunctional team (lets face it most teams are).  I love love love working from home, being my own boss and setting my own schedule.  My stress levels went from the height of the Empire State Building to ground level.....that is priceless. So this may not be a forever break from Community Nursing but it is for now.

I continue to teach face-to-face and online.  I taught two clinical sessions for the Philadelphia University I am employed by at a busy city children's hospital.  I had two awesome groups of students, I loved them all.  I have a formula I have developed the past couple of years that seems to work so I build on it.  First of all I think it helps that I really enjoy young adults, but I try to get to know them as people first, develop them as people as well as nurses.  That way I can see their strengths and what we have to work on.  Also, there is much published evidence out there that shows if a student believes the instructor cares about them they perform much better.  Think about the teacher in school you did best for, part of it may have been because you liked that teacher and thought they liked you.  We had our fare share of renal patients, lots of bronchiolitis, babies with GI issues etc.  The basics are great to teach, highlight how to work with the nursing process, document and most importantly build a relationship with the child and the family.  All my students passed their clinical and I hope it was a good experience for them

Online teaching continues.  For some mad reason I agreed to teach for yet another online school.  This was not a good idea as they were not organized, their communication was awful and their students poorly prepared.  It was the longest 8 weeks of my life but we got through it.  I quickly ditched them and told them I was not available to teach for another class.  However I continue with my original school (in Texas of all places) teaching community health, nurse leadership and care of the elderly and love it.  Was able to keep up all my grading and discussion on a recent trip to Rome.....aahhh the beauty of working online! 

So welcome back to my blog, now I am in look for weekly updates.  I missed you guys and I really missed blogging.  Got lots of ideas to rave about for the summer.