Happy Thanksgiving: What I Am Thankful For.... An ER Nurses Version #nurse #ernurse

Nurses are thankful for many things, but they seem to have a strange way of showing there gratitude sometimes. Only another ER nurse that has been in the trenches day after day (or night after night) understands the gratitude shown by another ER nurse. We are an odd breed of nursing creature, we are.
Humor helps us cope with the stress, chaos, drama, unrelenting flood of patients, death and dying, and our own misfortunes too. We have a dark side of humor that most laypeople just don't understand. Believe me, most of the time we are laughing with you and would never wish to hurt your feelings by laughing at your pain or loss. Laughter is a coping mechanism for healthcare providers.
When you hear laughing and joy in the Emergency Department, don't get upset and think the staff is just goofing off, not doing their jobs and have forgotten about you or your loved one.
Laughter is a good thing, it means the nursing staff is able to destress a minute,cope with the situation at hand, and they might be distressing together as a team.
You want your nurse to be happy.

This Thanksgiving I am so very thankful to be a nurse, for listening to my mother when she talked some sense into me at age 16. I wanted to be a veterinarian, but I don't do well taking care of sick animals (makes me cry) lol. So she suggested nursing instead since I was already working as a junior volunteer at a local hospital. Since 1979, I have loved being in the healthcare field, very thankful for such great nurses that took the time to show me their tips and actually believe in me.

Here is a list of other things that ER nurses can be thankful for:

• Great co-workers, nurses, nurses assistants and ancillary staff all included- we all work together for the common goal. 
• When you actually have a great manager that listens to you, believes in you, and is fair all around, not unwilling to roll up his/her sleeves and work along side their staff to get the job done.
• Educators that educate, consistently making sure staff is up to date on certifications, new policies, new procedures etc. Not just making pretty bulletin boards (pet peeve), also willing to work in staffing when needed.
• Equipment that works
• EKG machines that print clear readings on the first try
• A well stocked supply room (yes I am reaching here)
• Benefit plan that fits your family needs -- they are not all perfect, but at least we have them
• No Psych pts on your shift...lol
• Sober patients are always nice
• Nice big juicy veins- and the ability to hit your iv on the first stick all day
• QBT---quality butt time....lol when we have an unusual night
• Laughter with great friends

I can think of so many more things to wish for, but that might be another blog post.....

Tell me what your most thankful things are about being a nurse, I would love to hear them. 

This Thanksgiving What I am UnThankful For....ER Nurse Version

Working in the ER changes you as a nurse, sadly the chaos, tragedy, stress and constant living on the edge carves away at your inner being. Many nurses working in this environment for many years become cynical, hardened, and pretty much burnt to a crisp. These nurses begin to think about other fields of work to try, but learn that they are used to a certain lifestyle and pay. Without going back to school or changing professions completely they feel stuck in a dead end job.
They also make their co-workers around them miserable, the team player is no more. Vocal and verbally negative, they complain constantly about everything from their own health to their patients (the very patients that they are there to care for).
Working with a "negative Nancy or Ned" is one of my most "unthankful" things, it drains me and makes me sad.
If you are that unhappy with your job, you need to find a new one ...fast.
I come to work in a great mood, happy to have a job and after many years still love my job. Yes some days are more stressful than others, but all in all the patient is why we are there to work. Whether it is a negative nurse, doctor, or even part of the ancillary staff, that person can pull everyone down and make the work environment unhealthy emotionally for everybody, then the patients ultimately suffer.

Here is a list of Un-Thankful things:

• Negative Nellies (or Neds) - get your head out of your butt
• Uncooperative staff (that complain about every new change- even if it is good)
• Co-workers that consistently call in sick (and you know your health is worse than theirs)
• Constant complainers- something is always wrong with them- always sick or have a problem
• Nurse Bullies (Horizontal Violence) - nobody has time for that 
• Gossipers (mind your own business and let me do my job)
• Nosey Nosela's -- we all seem to have one or two that need to know it all (and tell it all)
• Superheros that know it all (but really don't) these nurses scare me- nobody knows it all
• Loners-- those that will not ask for help ( it is ok now to ask for help!)

I will stop there, I think you get the drift......lol , you all know what I am talking about if you are a nurse. 

Working in an environment such as the ER does not have to change you into such a cynical burnt out cinder. You are the key to your own happiness, accept gratitude for your career as a caregiver in such a fast paced role. Embrace your own wellness and take care of you, that is the most important thing you can do for your patients and coworkers. 

New nurses and nursing students, the time is now for you to be the change. One nurse at a time, one day at a time we can change the face of negative nursing environments and un-thankful lists. Happy, healthy nurses create a patient that is on the road to wellness. 

Stay tuned for my Most Thankful ER Nurse list ,coming up tomorrow.......... 

Save Those Ta Ta's and Feel Your Boobies.....Pass It On! #breastcancer #thinkpink #breastfriends

It is October and everything seems to be pink for breast cancer awareness, so why would we not talk about your boobies?  Time to get real girlfriend and save those Ta Ta's! Time to make sure you are doing your monthly breast self exam and doing it right. You have the power to stay ahead of breast cancer!

Early detection will save your life.  Be a breast-friend and buddy up to remind your BFF this month too!

Be Still My Beating Heart , Look at Your Patient First #screamandshout #cardiacarrhythmia #ECG

Does your heart skip a beat? Palpitate or stop suddenly ( I hope not).....well you might just have some arrhythmia going on. What is an arrhythmia you ask? A fancy word for an abnormal beating of your heart due to some electrical or mechanical abnormality.

If you are a nurse and you are reading this, you may be just as bewildered as I was once about heart arrhythmia's.
I learned to always look at my patient first and formost, know normal sinus rhythm , and then learn from there.
Is your patient pink, warm, dry and talking to you.....then you are ok!
Is the patient moving in the bed? is he scratching his chest? well you might just have some artifact and you almost jumped on your patient and scared the living crap out of him. Look for the simple fixes first unless he is grey, blue, or a nice shade of purple with no pulse.....then you can shout OH Sh@# and get some help......lol
Those crazy monitors are not always right, just because it says he is in Vtach, is he?? maybe, maybe not!
Practice, practice, practice and it comes with time and experience. A few embarrassing moments aside and you will learn, it has happened to all of us, don't let any ER or critical care nurse tell you that they have not been fooled before by a patients cardiac rhythm before, they are lying if they tell you otherwise.

Now what if you are not medically inclined? how do you interpret this chart?  Best thing is to find out what kind of irregular problem you or your loved one has and learn as much about it as you can from your cardiac doctors or credible websites. Knowing all these different cardiac rhythms if you don't need to will just overwhelm you right now. Learning normal is a great way to learn what abnormal is. Start with the normal ECG components at the top and the anatomy of the heart itself, it is a fabulous organ.

Original document is located here http://www.docstoc.com/docs/48034809/Arrhythmia-Recognition

Here are some of the most common Arrhythmia's to remember and be aware of if you are a nurse. Know these first and then work on the harder blocks etc.
I will review those in another post...............until later, have a great day or night!

Emergency Room or Urgent Care, Where Do I Go? #supportthescrubs #nurseup

Just when do you come to the Emergency Department(Room) to be seen and worked up for a problem? Of course Ebola is first on the list these days of problems people are scared to death of, but things like chest pain, shortness of breath, stroke like symptoms, severe abdominal pain, bleeding uncontrollably, sudden thunderclap type headaches (totally different from your regular headache), your newborn infant has a high fever etc. (see the infographic below for a good list of things to go to the ED or Urgent Care for) Are complaints that you seek emergency care for...

There are many people that seriously just don't understand the process of who needs to be in the Emergency Department and who does not! ER nurses and providers are totally frustrated with the minor complaints that show up on our door steps that could have easily waited until their primary care doctor, clinic or the urgent care was open. Even trying some home care measures before you run to the ER is OK, giving your child some Tylenol or children's Motrin and actually waiting to see if it works is A OK you know (or do you know?). Have you called your own doctor, pediatrician or dentist? most of them have an on call service? Or did you just panic and freak out?
Coming to the ER for something stupid and uncalled for just exposes you to more germs, adds to the wait times in all the ER's, takes a bed away from someone that actually may need it (yes really) and adds to the stress of the already overburdened system. (Yes I am on my soapbox today)

Coming to the ER with complaints like these drive me nuts: (yes these are actual complaints that I have heard as an ER nurse over the last 25+ years) --no names of course to protect privacy, some things have been changed. Picture the look on my face when I heard these complaints.....lol

• A cough for 3 years  ( today was the day to get checked out)
• My toothpaste made my gums hurt (she really wanted a work note and narcotics)
• My big toe is sore (pt had new shoes and wanted a work note)
• My toe nail polish made my toes red (rash) - noted pt had on red nail polish
• My partner cheated on me and I want to be "checked" (she actually cheated and had 3 std's)
• I have something stuck in my teeth ( omg you don't want to know what it was)
• I have had a condom stuck in my vagina for 3 months (it was a French tickler- smelled so good)
• My period is way to heavy... ( she was crazy actually )
• I have had chest pain for 3 years (and I needed a ride in the ambulance closer to my house)
• My vibrator is stuck and I need the batteries changed soon ( you can only imagine)
• I have money stuck up in my vagina and I need change for the laundry mat (a frequent flyer)
• I need you to give my child Tylenol here in the ER so I will have money for the laundry mat.
• I have a rash on my hand (no rash to be seen anywhere)
• My child has a fever of 99.1 (child running all over the room eating chips and drinking Pepsi)
• I flushed my pain medication down the toilet by accident and need refills (oh by the way I am from out of state) -- wanted drugs, was lying of course
• I fell off the roof in 1986 and my back still hurts, I want my back surgery now!! (it is 2006 now)
• My baby needs to be checked (had not been to well child checkups since mom had been busy she said)  (I want a check mark stamp)
• My child needs his football physical (mom was told that the ER does not do physicals, she wanted to check in and wait anyhow) (the doctor told her no after she waited 3 hours)

I could go on and on with these ridiculous type of complaints that are all actually real, these patients also think they should be seen first, even before your chest pain or stroke symptoms, they can make the most noise in the lobby. One lady told me once "I don't care if that baby is not breathing, I am going to be late getting home and my probation officer will find out I am not at home, so I need you to write me a note NOW!!!" I just smiled at her and walked away..................

Next time you are in the ER or even a Urgent Care facility, tell the nurses and providers thank you for all the hard work they do, putting up with bull-crap and just smiling-- then saving your loved one's life.

#supportthescrubs 

On a serious note, if you are truly sick or just don't know, then by all means come in to the ED. I would much rather help you make that decision than you stay home having chest pain, shortness of breath, an allergic reaction to something or stroke like symptoms. Trust your gut, especially if you are a parent, you know your child, if they are just not acting right.... seek treatment... call your peds doctor first and then come to the ER. Most pediatricians want to talk to you first before you head to the ER. Unless your child is an infant under 90 days old with a fever over 100.5 rectally, that is a real emergency and needs to be seen, unless you have made other arrangements with your pediatrician already. 

Call 911 if you need to, they can treat most emergent problems in the field before you even get to the ED. They are highly trained in their profession and can make the choices you might not be able to in an emergency. 

It is really easy to send you home, when we have ruled out all the bad things that can "kill you dead today" . It is much harder to tell your family that you are gone :( 

Weeeeeeeeeee! little piggie

Help For Domestic Violence: Resources For Women And Teens #Octoberawareness #domesticviolence

Do you know someone that is in an abusive relationship right now, or is that person You!  Here are some resources that can help. Please report abuse, who else will speak up for her?

Domestic Violence Resources For Women: 

National Domestic Violence Hotline:Toll Free: (800) 799-SAFE (7233)
Toll Free: (800) 787-3224 (TTY)
www.thehotline.org

National Network to End Domestic ViolencePhone: (202) 543-5566
www.nnedv.org

American Psychiatric Association (APA)Toll Free: (888) 35-PSYCH (77924)
Phone: (703) 907-7300
www.healthyminds.org

National Coalition Against Domestic Violence
Phone: (303) 839-1852
Phone: (202) 745-1211 ext. 143
www.ncadv.org

The National Center for Victims of CrimePhone: (202) 467-8700
www.ncvc.org

Futures without Violence
Phone: (415) 678-5500
www.futureswithoutviolence.org

National Resource Center on Domestic Violence
Toll Free: (800) 537-2238
www.nrcdv.org

The Battered Women’s Justice Project
Toll Free: (800) 903-0111 ext. 1
Phone: (612) 824-8768
www.bwjp.org

National Battered Women’s Law Project 
Phone: (212) 741-9480

WomensHealth.govToll Free: (800) 994-9662
www.womenshealth.gov

National Center on Domestic Violence, Trauma & Mental HealthPhone: (312) 726-7020
www.nationalcenterdvtraumamh.org

National Teen Dating Abuse Helpline
Toll Free: (866) 331-9474
www.loveisrespect.org

Safe Place
Phone: (512) 267-SAFE (7233)
www.safeplace.org

Break the CyclePhone: (310) 286-3383
www.breakthecycle.org

Rape, Abuse and Incest National Network (RAINN)Toll Free: (800) 656-HOPE (4673)
www.rainn.org

Health Resource Center on Domestic Violence
Toll Free: (800) 313-1310
www.futureswithoutviolence.org/content/features/detail/790/

A Women’s Guide to Alcohol and Drug Rehabilitation
Toll Free: (800) 993-3869
www.recoveryconnection.org/alcohol-drug-rehab-for-women

Teen Domestic Violence Resources 

National Teen Dating Abuse Helpline
Toll Free: (866) 331-9474
www.loveisrespect.org

Break the Cycle
Toll Free: (888) 988-TEEN
www.breakthecycle.org

Love is Not Abusewww.loveisnotabuse.com

Teen Outreach ProgramToll Free: (800) 300-1080
www.teenrelationships.org

Maryland’s Peoples Law Library
www.peoples-law.org 

Safe YouthToll Free: (866) 723-3968

KidsHealthwww.kidshealth.org 

SeeItAndStopIt.Orgwww.seeitandstopit.org

WomensLaw.Orgwww.womenslaw.org

Another page with some great resources : Here 

Warning Signs if you think you or a loved one is in an unhealthy relationship 

Please, Please seek help before you are just a statistic on a page or another name on a toe tag, don't fool yourself thinking it will end or he will stop................he will not! Call today and get some help, even presenting to a local Emergency room and telling the nurse you are being abused will start the process to get you the help you need. Call 911 if you are in danger now, keep yourself and your children safe, you deserve better, it is NOT your fault!!

e-Cigarettes- The Burning Truth [infographic]

So you are puffing away now on your new found e-cigarette thinking you have made a perfect healthy choice, when you discover they might not be all they been raved about. Just what is in an "e-cigarette"? 

Advertising themselves as “healthy alternatives” to cigarettes, electronic cigarettes attempt to recreate the act of smoking in a much more synthesized, scientific fashion. Using a rechargeable battery powered heater, e-cigarettes vaporize liquid nicotine as smokers take drags through the electronic cigarette’s vapor funneling system. The debate is still out on the "healthy" aspects of these cigarettes, as a healthcare professional I don't like them, but I would rather see you use this that smoking a nasty old conventional cigarette. It is a step in the right direction, helping you to quit I hope. 

There are no long term studies out yet, the FDA has not weighed in, nor approved any kind of e-cigarettes at all yet as an official smoking cessation device (so there is a clue for ya). 

Nicotine is still a drug, even though you are not getting the tar from tobacco, the nicotine has effects that do bad things to your body such as

• stroke
• cardiac ischemia events
• hypertension
• peptic ulcer disease
• high cholesterol
• esophageal reflux
• arterial constrictions
• slow wound healing 
• reduced immunity 

Infographic credit to Infographicdaily.com 

Please choose wisely, make the best choice for your health. You only have one life, live it well.