A Letter From A Nurse

“Come walk in our shoes for a 12-hour shift. Come see the joy, the tragedy, the comedy, the 100 ways we are pulled and pushed, then rate my “pleasant greeting”, “answers call light in a timely fashion”, “states name of patients.”

Use the bathroom now, because you might not get the chance again until your shift ends. Wear comfortable shoes. Don’t worry if they’re clean. They’ll end up with blood and vomit on them.

We are the patient’s advocate, the doctors’ eyes and ears, and everyone’s scapegoat. We can page your doctor but we can’t make that doctor magically appear. We check your stitches, wipe your blood, drain your pus and empty your bedpan.

Nursing is a tough job, but we’re tougher. We’ve been yelled at by administrators, supervisors, and doctors. We’ve been kicked, slapped, punched, spat on, and sexually harassed by patients in various states of delirium, mental illness, arrogance, and intoxication.

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Nurse-Staffing Ratio: Patient’s Perspective

The patient’s condition itself is a major piece of the nurse-staffing ratio. For instance, a patient that is fresh out of surgery and arousing from anesthesia is considered to need a nurse-staffing ratio of 1 nurse to 1 patient (1:1) for the first hour of recovery. This usually takes place in the Post Anesthesia Care Unit (PACU) with nurses that are certified in Advanced Cardiac Life Support (ACLS).

When deemed “stable”, the patient can be transferred either to an Intensive Care Unit or to a Medical-Surgical Unit depending on the patient’s diagnosis and/or condition. For example, an uncomplicated appendectomy would go to Med-Surg but an open-heart patient would go to Cardiac ICU.

The OR, PACU, Pediatric ICU, Cardiac ICU, Medical ICU, Surgical ICU, Neonatal ICU, Labor & Delivery, and the ED – are all considered to be Intensive Care Units of a hospital. Patients that are admitted or evaluated in these units are (or are about to become) high-risk patients. The nurses working in these units of a hospital are highly specialized and the best of them are certified in that specific type of care.

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Nursing Specialization – Case Management

Case Management Nursing

There are three main responsibilities that individuals in the case management nursing field are charged with. They review the way hospital services are utilized, they plan patient discharges and they even ensure high-quality service throughout the facility. They also work to come up with long-term care plans for individuals with chronic or terminal illnesses.

Utilization of Hospital Services

An individual in this specialized nursing field will stay in close contact with patients, physicians, hospital administration and insurance companies to review the ways in which services are delivered.

These individuals may spend countless hours poring over patient charts and comparing information to ensure that these patients are getting the best care available to them.

They may also work with insurance companies to provide information about treatments that are deemed ‘medically necessary’ for the patient; this is sometimes necessary before health insurance companies to pay for certain treatments, surgeries or medications.

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Nursing Interventions – What You Should Know

Nursing Interventions are actions by nurses that will enhance their patients’ health and/or comfort. Nursing Interventions form the backbone of all nursing activities. For nurses who think about advancing their profession, mastering Nursing Interventions is absolutely critical.

What are Nursing Interventions?

The Journal of Nursing Education describes Nursing Interventions as all tasks nurses do for or to their patients and/or all tasks nurses do that will lead directly to their patients’ outcomes.

Nursing Interventions can be specific or general and indirect or direct. The areas of Nursing Interventions include Mobility Therapy; Sleep Pattern Control; Diet Compliance; Infection Control; Positioning Therapy; Alcohol and/or Drugs Abuse Control; Bedbound Care; Postpartum Care; and Energy Conservation. But there are more fields where Nursing Intervention plays a crucial role.

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The Good Nurse …but Good Person?

I’ll be the first to admit I love working with a good nurse. Give me a good nurse any day! and we can work short-staffed, under pressure and come out smelling like roses with cheerful and sunny attitudes. Alternatively, give me a fully-staffed shift of slackers and complainers, and we come out overworked, underpaid, grouchy, tired and beaten. Yes, a good nurse is worth their weight in gold.

The good nurse can handle his/her patient care assignment with minimal or no unnecessary emotional drama. I enjoy both the novice and the expert nurse when their work is efficient, comprehensive and professional.  And, thankfully, most nurses are sincerely good.

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Nursing Interventions

While it is much easier to revel in the knowledge of our strengths and bask in the praise of others, it is time to stop beating ourselves with our weaknesses. Who, as an adult nurse, needs to be reminded of those anymore? High time for respect for nursing interventions, the backbone of our nursing profession!

That you know what your personal skill weaknesses happen to be is all that matters. That you spend any time at all trying to change a weak skill into a strong skill at this stage of life is a waste of valuable time. Abandon the Weaknesses! Focus on your strength. That will allow you to be good at nursing interventions and enhance your patients’ health and wellbeing.

A strength is not necessarily defined as ‘something we are good at’ but, rather as something we merely enjoy. It is an activity that completely envelopes our minds and hearts while we are engaged in it. We enjoy the time spent and we are inspired when we are done. I enjoy teaching future nurses how to pass the GED using Best GED Classes and I know I am very effective, I recommend using BestGEDClasses platform because it’s free and has a lot of practice tests. Without a high school diploma or GED, there’s no way anyone can get into the world of nursing.

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“Are You New Here, RN?”

If the answer is “Yes” – whether you are a new grad or an experienced transfer, it will be in your best interest for you to mind a few simple principles.  They are easy to accomplish, yet effective and powerful in their implementation.  Good luck! and Welcome!!
Just take a look at this video about the five most common mistakes new RNs make:

You are here to learn our ways, not the reverse. You were chosen from a handful or more of others to join us – don’t make us doubt our hiring abilities by becoming obnoxious about “how you do it.”

Be quiet and observe. The working staff have many things to show you that you will never get from the policy manual or conversations.  Interpersonal behaviors, customer service, times to implement certain routines, mannerisms for phone conversations, time management, and clothing options only come from clear observation.

Smile.  Alot. When you smile, you are approachable.  When you scowl, you appear disapproving – and frankly, no one cares to engage another human being whom they think doesn’t like them or whats going on.  So, even if you don’t like someone or whats going on, smile. And then: smile more.

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RN Leaders/Academics: No Respect Theory

Ever notice the measuring tool by which we rank our nursing co-workers and charge nurses to decide how to respect them? How to decide if in our verbal and mental descriptions we tag them with “…he/she’s a Good Nurse” or label them with “…he/she’s Not a Very Good Nurse”? In short, how to decide whether or not this colleague has any merit whatsoever for our respect or even our attention?

It is their clinical prowess. Their bedside skill. Their ability to feel, know, acknowledge and rally the clinical team to get the impossible done for the patient. That it (whatever ‘it’ is this time) is right, timely, and physiologically correct leaves us as bystanders admiring them for months and years. We want to “be like that when we grow up!”

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Nursing Leadership 101

This is a blog. A personal blog. A personal and self-supported space on the Internet where I get to write what I want when I want about whatever I want – with only the best intentions, of course.  It is ok if you disagree with me – a little or a lot.

If you think I am talking about you but you are not specifically named, then I am not talking about you. If you think you know the situation or person to which I refer but I did not give the correct details or the person’s real name, then you are mistaken. I am a GED graduate, nursing educator, nursing leader, speaker, and students motivator. I also volunteer as an online GED classes instructor at Best GED Classes and Covcell.
… if it’s not fun, then you’re reading it all wrong.

This blog is sometimes sarcastic and purposefully edgy. This site in no way reflects the opinions of the hospitals I work or organizations I volunteer.Continue reading

Online LPN Programs

The idea that one could become an LPN by taking a course that is entirely Internet-based is, if you stop and think about it, a truly silly one. Yet every day thousands of Google searches are performed by people looking for online LPN programs. Such things do exist, in a way, but the whole thing is a little more complicated than it seems.

Why Real Online LPN Programs are an Impossibility

Nursing is one of the most hands-on jobs that anyone could choose to do, and therefore clinical practice and experience, in the real world, is an essential part of any nurse’s training, whether they want to become an LPN or an RN. In order to work as an LPN, every state in the US requires that an individual is licensed, and there are clinical hour requirements attached to that license. And yet there are still those who believe in the fallacy that online LPN programs allow you to become a licensed practical nurse without ever leaving the comfort of your own home.

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