All throughout my childhood, I dreamed of becoming a doctor. I remember playing with my plastic stethoscope and mapping out the dream estate that my millions of dollars would buy for me and my family.

Through high school, I ended up working as a pharmacy technician for a retail pharmacy, which made me decide that pharmacy school was the path I should follow; realizing all the legality and time-limitations (in patient care) that doctors faced turned me off to medicine.

So, I applied to my dream college, which was a liberal arts schools as pre-pharmacy, but very shortly after starting my first semester of chemistry, I decided that I couldn’t do another 11 semesters of those classes (sick).

So, I talked to my college friends, most of whom were nursing majors, and decided that I could see myself as a nurse. I switched my major, did a semester of summer school to get caught up with pre-requisites, and then my nursing major was officially underway.

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Nursing Image & Ability to Influence Politics

images-14…your job is easy to but I don’t want to be a garbage man. Nurses are a mix of maid and babysitter anyone with an 8th-grade diploma could do it, it’s not hard to do. I guess good nurses are around because who else would get coffee for the doctors.

This is an inflammatory comment left by a fool in the midst of a jumble of comments following this article from Michigan. The comment is asinine and I usually would pay it no attention, but I am hearing and reading this genre of spittle more and more often.

This mindset definitely makes me wonder if this is a sad backlash of our economy, our union activities and the employment situations in which nurses are finding themselves – more “labor” (believed by the masses to be unskilled, at that) than “professionals.”

Are we not worthy of respect and a seat at the Big Boy Table? Do they understand how much work we have and that our education is demanding?!

Here are some of my observations:

Neither medical nor legal professionals are standing on State Legislative lawns with signs.

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We’re All Adults Here

images-40I was taking care of a younger (read: in his 50’s) patient last week. He developed flash pulmonary edema following severe mitral valve regurgitation requiring him to be intubated, treated, extubated, transferred to our hospital for mitral valve repair. He was intubated for surgery and then post-operatively we had a hard time getting him off of the ventilator (he was on 100% FiO2 and 10 of PEEP just to keep his SpO2 in the mid-80s).

I was his nurse on the day of surgery as well as post-op day #1, so the first day he was still under anesthesia, but when I walked into this room on my 2nd day with him, he was wide awake and able to communicate with me more than I had been able to communicate with any other patient prior to him in my career.

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Nursing Orientation – Good One or Bad?

If you have ever taken a job in a hospital facility as a clinical staff nurse, then you most likely endured a clinical orientation. Did you love it?!! The really great orientations are imprinted on our psyches and embedded in our hearts. …The really bad ones are enough to make anyone quit the practice of nursing. Even non-nurses. I became a mentor to 2 wanna-be neonatal nurses, this post is dedicated to them.

Since those really are the only two choices – a Good O or a Bad O –
the Muse, RN is happy to start the following list in service to:

our future co-workers
…whose hearts deserve our warmest welcomes & best instruction
our Preceptors & Nurse Leaders
…who have always had the ability to make it so.

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ICU Nurse Notes – Officially Official

fitness-nurse-modelI have really enjoyed blogging over the last few months, most recently with my old account that some of you have been following. As I realized how much I was enjoying it, I also realized that I wanted to get a little more “official” with a domain.

So, I enlisted the help of the one and only Chuck Reynolds (an amazing web developer who also happens to be my boyfriend) to merge my old blog onto my new domain. He has shown me a great deal about reputation management and personal branding, both of which I have embraced.

I am an extremely passionate person – I throw myself wholeheartedly into anything and everything I do, and my work is no exception. I love my career, through all of the ups and downs that I experience each and every day and this blog has been an outlet for talking about those out-of-the-ordinary days.

For those of you who may not know me, check out the “About” tab at the top of this page and you’ll get the dirt. If you’d like, you can subscribe to this blog’s RSS Feed to keep up to date.

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Revisiting Complications of a Cure

images-30Curing a disease need not cure the patient.

The patient’s letter was short and angry. I had not helped her; she did not plan to return to see me. And, she didn’t; she might as well have moved to Australia, such was her silence.

Six months earlier, she had undergone a temporal lobectomy for epilepsy, present since her teens, usually manifested by episodes of being disconnected from her surroundings, and only partially controlled by medication. I had been her epileptologist for a dozen years, guided her through two successful pregnancies and assuaged her nervousness about her condition several times a year. Her brain scans showed a stable cystic lesion. We had often discussed surgery, but she was not ready until she had a major motor seizure at age 35, almost 20 years since one other similar event had heralded the onset of her condition.

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Giving Up Patient Care for a Non-Clinical Career

portrait of a blond woman

While clinical practice has worn me down, will I feel lost if I abandon it for a non-clinical career?

On a day when there’s been one snafu after another in the OR, a four hour clinic lasted six, several patients were unhappy, and an administrator 20 years your junior made you feel like you were 12 years old, you start thinking of those far away evergreen hills where there are no patients, you wear a business suit and everyone is cordial. Nirvana; no dictations to tack on to the end of a stressful day, no risk of calls coming to home or worse yet waking you from sleep. Beam me up?

If you have a lot of those days you may head for Nirvana and to your dismay find a hell. A hell of deadlines, budgets, quarterly numbers, job insecurity, hyper-competitiveness, stress because it’s new, stress because it’s stressful – and, if all that wasn’t bad enough, you’re feeling like you really miss taking care of patients, even the depressed, angry, non-compliant ones who may have caused you to head for the hills in the first place.

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Careers in Medicine

goalsetting-300x227Good Goal Setting

There are all sorts of mnemonics out there to help you achieve your goals. SURE for specific, understand what’s involved, realistic, and enthusiastic. Or, SMART for specific, measurable, attainable, realistic and tangible. Somehow these don’t cut it if you’re after bigger fish than a better exercise schedule. So, I, less sure and smart, offer the following formed from my own school of hard knocks.

1. Never set out alone. Share – it lightens the load and adds incentive to not quitting easily.
2. Being vulnerable and humble are winning qualities off of Wall Street. Our educational programs, requiring one big goal every few years, are not necessarily great training for the real world.
3. Pick reasonable timelines. I like goals in the 3-9 month range.
4. Stick to a few goals.
5. Try to be both practical and inspirational.
6. Make your goals considerate of others at home and at work.
7. Have at least one goal that incorporates unhinging yourself from your past.
8. Take a chance.
9. Expect and embrace the unexpected. Great things can come along, if you’re open to the possibilities.
10. Revisit your goals regularly to avoid the perils of aimless drifting.

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Lessons Learned from Allina’s EMR Implementation

northfield250x130Allina Hospital and Clinics went live in 2007 with Excellian, its landmark electronic medical record (EMR) system. Allina, the largest health system in Minnesota with 11 hospitals and 65 clinics, has achieved its vision of “one patient, one record” with the completion of the project, integrating Epic Systems products at the core with other biomedical, administrative, bed management, and picture archiving and communication systems.

Excellian was implemented on time and within 2.5 percent of its original $250 million budget. The project has been heralded as the first of its kind and as an example for other organizations to follow. And it would seem that Healthcare Information and Management Systems Society (HIMSS) agreed – the organization selected Excellian to receive its prestigious 2007 Davies Award for healthcare organizations.

Kim Pederson, former Allina vice president over the Excellian implementation, who now heads her own consulting firm, KP Healthcare Consultants, shares some tips for hospitals undertaking a similarly challenging implementation.

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The Big Deal

The Big Deal is….who gets to establish the nurse-staffing ratio?

Really.  That is what all the fuss is about.  Control.  The patients have none.  The hospital has all.  The practicing nurses want some.  …And the nurses want the state’s legislature to make the hospitals give them some because there has been no effort on the hospital’s part to do so without this threat.

Patients do not want to be involved in this decision.  They want, expect and deserve proper patient care (a la 1:1 nurse-staffing ratios) and customer service (a la Disney).  Hospitals and nurses that can provide this seamless type of care to patients (not the 1:1 part; maybe 1:4-5?) throughout their facility will not have negative patient satisfaction comments and ratings.  Patients will love this!

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