5 Tips for Nursing Students

As a nursing student myself not too long ago, and a nurse who has had a few students now, I have some tips for nursing students during clinicals.

1) Don’t take the nurse’s computer. I know it seems so unfair as a student when you have to stand up to use the computer but… c’est la vie! When you’re a nurse, you can sit down, too. Stop. No. Don’t take my computer! Thanks.

2) Communicate, communicate, communicate. Tell me what you’ve done. Tell me what you’re going to do. I’m sorry if I don’t have time to go through everything with you, but reach out to me anyway. I promise I won’t bite your head off.

3) Jump in there. Don’t stand back – get involved. Offer to help, ask what I need.

4) Be polite. Don’t pretend like you know everything. Things are different in the hospital than in the nursing lab. You can always ask why but ask politely. And if nurses are a little snippy, understand that we are very busy right now. That’s not an excuse but perhaps it’s a little more understandable.

5) Have fun! Drink it in! Figure out if this is what you want to do. There are so many areas of nursing you can go into… is this what you want to do the rest of your life?

I’m sure I will have more to come!

 

Thoughts on Casey Jones

I have had the song “Casey Jones” stuck in my head the past two days. This is the only Grateful Dead song that I own; I bought it after hearing it on classic rock stations. Besides the reference to drug use (“Ridin’ that train, high on cocaine”), the song is all about the disaster in which Casey Jones, a railroad engineer on the Cannonball Express who died in a crash in 1900. The parts of the song that have stuck in my head are “Casey Jones, you better watch your speed… Trouble with you is the trouble with me, got two good eyes but we still don’t see.”

Based on my Wiki-research, Casey Jones was not, as far as anyone can tell, a drug addict – in fact he may have been a teetollar! He was a good engineer with a few rules infractions for speed, normal at that time as the railroad companies were always pushing their trains to arrive on time or early. He was a family man with three kids, just trying to do well at his job. The accident that happened may or may not have been his fault; no one knows for sure. But ultimately, he was a hero who chose to stay on the train and apply the emergency brakes, with the result that he was the only fatality.

The song and story show me that speed can be killer (and I’m not talking about the drug although that’s also true). Rushing is dangerous. Rushing through life, through work, causes us to take shortcuts and lose sight of the meaning and intention of what we are doing.

I think God is reminding me of this because I have recently had a few over-committed days. Many times I will look at a blank day on my calendar, and – quick! – try to fill it up with activities, instead of allowing God to own my time and guide my decisions. And what’s the result? Things fall out! The grocery shopping or laundry doesn’t get done. I never have time to make that phone call I meant to make.

In medical settings, rushing can be VERY dangerous for a variety of reasons, and that is why you will very rarely see doctors or nurses running anywhere except a code. Usually, we have more of a “speed walk” going to prevent both panic and falls.

Speed forces us to take shortcuts. Shortcuts may endanger patients. As it says in the song, “We got two good eyes but we still don’t see.” How many times have we missed something that, if we were rushing, we would have known was serious?

Because speed isn’t everything. Integrity is. We have to take time, take responsibility, take a breath and prioritize.

Casey Jones didn’t see the signals, if there even were any; he turned the corner and saw the caboose and knew a collision was imminent. As it says in the song “Come round the bend, you know it’s the end…” He stayed on the train because that was his responsibility.

In nursing, we don’t abandon our patients who need us, even if it’s lunch time, even if shift is over. Even if we are really really busy. No, we find the time, make the time, to pay attention. In life and nursing we prioritize. Time is a gift.

How are you using your time?

So… What Is Anthropology?

When I tell people that I majored in anthropology, many people mention dinosaur bones. Not so much. Others discuss Stonehenge, which is a little closer to the truth.

Believe it or not, I had never heard of anthropology (the study of humankind) before I started at college. But once I looked into it, I thought it was the most brilliant idea. The study of people groups! I had always felt a little bit like an observer, on the outside looking in. Now I discovered there was a term for that: participant observation.

When I found out that anthropology is divided into four main areas – archaeology, physical anthropology, cultural anthropology, and linguistics – I was even more excited. I wouldn’t have to pick! Everything was available, under one roof!

When I was much younger I wanted to be an archaeologist. Inspired by Indiana Jones and an excellent book about Inca treasure hunting called Cruise of the Condor, I looked forward to digging up secret tombs in the depths of crumbling temples. As time passed, I forgot about particular aspiration and moved on to other possibilities – nursing, writing, teaching.

But in college, I rediscovered that childhood ambition. And when I learned that one of our professors went on digs to Mexico, I was definitely hooked.

I loved my cultural anthropology class. I loved all the random stuff that we read about, the sampler of articles from many different books and periodicals, everything from an article on sugar and the sugar trade to geriatrics. Pretty early on, I knew that I was going to pursue anthropology as my major. I had never met anything I loved learning and writing about quite as much.

Early on, we learned about the concept of cultural relativism. The father of anthropology, Franz Boas, came up with the idea – that our perceptions, our worldview, is not absolute or distinct, but integrally tied to our culture. In order to understand other cultures, we have to see what is happening from their point of view rather than our own. We have to step out of the box of “ethnocentrism,” the belief that our culture is superior to every other, and instead accept each culture’s beliefs and mores on its own merits.

When I learned about cultural relativism, I felt like I had made a major discovery. I felt free not to judge people.

I really liked the Anthropology department. Not the location – no, they stuck those wild, cheery, energetic anthropologists in the basement. You know why? Because they could handle it! Because the anthropology professors were the motivated, caring, thoughtful kind of people I wanted to be and they transcended the basement.

Over the next three years, I learned many interesting things and had many fascinating experiences. I took a Gender and Power class and interviewed female pastors. I went to Mexico and did archaeology. I took classes on African cultures and studied the blurry and insubstantial concept of race. I did an honors project on Baptist Latino churches.

I have never regretted my major. Anthropology was the perfect pre-nursing major because it taught me about seeing things from other people’s point of view.Through anthropology, I learned how to talk to people, to  listen to people. I discovered how irrelevant race is. I mean it when I say this: it opened my mind.

So that’s what anthropology is – the study of culture and people. A discipline that seeks to encourage mutual understanding. A field of study that we could all learn from.

Because how can we love our neighbor if we don’t try to understand him or her?

 

The Importance of Forbearance

Ephesians 4:1 “I therefore, the prisoner of the Lord, beseech you that ye walk worthy of the vocation wherewith ye are called, With all lowliness and meekness, with longsuffering, forbearing one another in love.” (KJV)

For some reason I really heard the word “forbearance” tonight from the Holy Spirit. There are many other ways of saying the same thing. “Be patient with one another” or “bear with one another” but “forbear” just seems so much more serious. Perhaps because it has a sense of intention, as in foreshadow, forewarn, combined with the sense of picking up a burden and bearing it.

I think He reminded me of this passage because of something that happened at work. Sometimes even friends, coworkers, and family members that you love can drive you crazy. Perhaps they are doing something you REALLY wish they wouldn’t, or not doing something they SHOULD.

Perhaps you are in the right in the whole thing and you really want to point it out…

(and the thing is – if it’s a safety issue, you should! or a moral/ethical issue where you have spiritual back up, they should know about it! but if it’s a pet peeve…)

sometimes you have to back off and say, “okay. This is not part of a pattern. This one I’m going to let roll off my back because if we discuss this, it might lead to a big messy confrontation that will take time away from more important issues. This time, I’m going to forbear. In love.”

Some people might object. “You can’t bottle up your emotions! they will EXPLODE! all over the place!”

And I agree; if there’s a pattern you should definitely let that person know the danger.  But I find if I let the moment of frustration pass, often it will go away completely, and things will be even better.

If I am willing to be the lowly, meek, longsuffering one, God will meet me more than halfway with the patience to get through that situation.

You know why? Because He has always been the One forbearing with us in love. Because he is Grace itself.

He reached out to us even though we not only got on his nerves, we sinned all over the place! We are reckless, ridiculous sinners! He would have been justified to leave us out in the cold (or in the fire, if you prefer that image… being in Minnesota I find cold much more powerful this time of year…)

But he didn’t. He ignored our faults. He came that extra mile. He died for all of us. The more perfect don’t get better treatment; equal opportunity! He doesn’t look at our sin, he looks at our need for him.

And that’s really what we need to do. Look at the other person’s needs, not just our own.

“Right now I’m not going to think about the fact that you did X bad thing and said Y negative thing and did not help me with Z. I see that you need A, and I’m going to forbear X Y and Z and help you with your need, as God helped me with mine.”

Disclaimer: Don’t think I’m always very forbearing! I’m not. This is written out of the realization of my own struggles and needs. This is the lesson that God has put on my heart right now.

Hopefully it will speak to you as well.

I’d Like to Thank…

After my pleasant shift yesterday, fate had it in for me. Any day in which you have to ask “is this what x bad symptom that I’ve never seen before looks like?” is a tough day.
But I got through it to my oscar watching party with some help from my fellow nurses. Who am I kidding? A LOT of help.

First of all, a big thank you to everyone who answered my endless questions “where are-”

Thank you nurse that took care of one nearly fainting patient when I was taking care of another.

Thank you PCAs for helping so much with baths, bathroom, vitals, and everything. I’m sorry I was always running out of the room to answer phone calls.

Thank you to those that covered while I took a 20 minute lunch… And not rolling your eyes too much…

And thanks to the (float!) resource nurse who offered to take a blood sugar to make my day better.

Thanks to my patients for being (mostly) patient and chill.

Thank you HUCs for putting that patients sandwich in the fridge for me.

Thanks to the charge nurse for advocating and wasting with me and giving me a sweet admit at the end.

Thanks to the services for being polite and responding quickly to my incessant pages.

Thank you God for getting me through…

Thank you!!!

Lunch in the Time Warp

12 hour shifts are timeless.

In all honesty, I would rather work 8’s. I quite enjoy my 3 8-hour evenings a week more than I would enjoy 3 12’s. Why, you ask? It comes down to quality of life. After a 12 hour day shift, I have maybe 4 hours of productive off time before I have to fall into bed and be ready for the next day. Whereas with 8 hour shifts, I have 8 hours, that’s TWICE AS MUCH down time, to read/run errands/do laundry/spend time with my husband.

(Sure, mathematicians, I get paid 2/3 as much but money isn’t everything…)

But when I am working a 12 hour shift, I really don’t mind it. I find myself in a time warp. I know I’m going to be at work all day (or all night) and I may as well accept it. The day streams by in its series of neat boxes; medications, treatments, vital signs, lunch, repeat. Before I know it, the next shift nurses are swarming like – something loveable and friendly that swarms – to get report and I can go home.

Today the time warp was nicely broken up by lunch with some float colleagues. As floats, we don’t see the same people day after day. We get to know nurses on different floors but it takes a little more effort to build friendships when both the people and the territory change every shift.

But coworker hang-outs are totally worth it! I can’t express how relaxing it is to chat and commiserate with other float nurses. We can discuss the idiosyncracies of our different floors, complain about switching between days and nights, and share notes on all our mutual float friends that we rarely see.

I am very thankful for my job because, from what I read, a guaranteed 30+ minute lunch is not common in many nursing environments. But it adds so much to job satisfaction. That chance to step away from the craziness of the floor, leaving my patients in another nurse’s capable hands, eat, drink, go to the bathroom, and talk… After a good lunch I can return to work refreshed ready to run my behind off for the rest of the shift without any problem.

Thank God for nursing lunch!

Ensemble

Definition: A unit or group of complementary parts that contribute to a single effect.

We went to hand bells tonight. I just started playing with the handbell choir in the fall and have really enjoyed playing (and am slowly getting better at it). The fun thing about the bell choir is the chance to play with other people, to build camaraderie with the group. If I just played my two bells by myself, that would be a pretty sad little piece of music. The beauty of the piece emerges from the collective efforts of the group.

What makes a good handbell choir, or a good flute choir, or any good musical ensemble? Watching and listening! We all have to watch the director in order to maintain the same pace. We need to pay attention and count our measures so that we are, literally, on the same page.

It is equally important for us to listen to our director and to each other. Our director always points out the hard passages and suggests different strategies for approaching them. Sometimes he will even count us through sections the first few times.  When we did a jazzy piece, he had us clap the rhythm for him so we could master the off-beats.

Finally, we really need to listen to each other. If we are in a run, and we are not listening to each other, just counting, that run can quickly degenerate into a mess of notes. We need to listen to who has the melody so that person can bring out their notes while we play softly. Most of all, we need to listen to the overall flow and musicality of the piece.

We also need to cooperate. Sometimes we can’t play all those bells in the right order. We have to have our neighbor, who doesn’t play any bells for 29 measures, grab that tricky chime. We have to negotiate who turns the page. 

A lot of these lessons translate directly to the real world. Church committees, nursing units… paying attention to the goal, watching, listening, and cooperating are the keys to good teamwork.

In handbells, that goal is worship. Not creating pretty  music, although that is a nice side effect. No, we have to lay aside any petty feuds, open our hearts and minds, listen, and offer our gifts with the rest of the ensemble to God.

Reminders for Family Members

Yesterday, I floated to a unit where people of all ages are recovering from a variety of problems. Strokes, falls, car crashes, medical issues… this unit helps people get back on their feet. As I sat in the nursing conference room, people were discussing family members that had fallen or been in accidents.  Falling is unfortunately frequent up here this time of year – it is cold and slippery and dangerous to walk outside!

When I got off work I received a call that one of MY family members had an unfortunate accident and had to go to the hospital.  As I learned the details through texts and phone calls, I couldn’t help wishing that I could be right there, at the bedside, supporting, helping, and advocating.

So, as a family member and a nurse, here are my thoughts on that relationship.

1) Family members are a really important part of nursing care especially on a general care floor. The fact is, no matter how good of a nurse you have, he or she can’t be in three rooms at the same time, or watch every little change in the patient’s condition, or know everything about that patient right away. Family members are really important as advocates for the patient. Does your family member look different? Are they in pain? Do they take their pills whole or crushed in applesauce? Families are important partners in the process.

2) However, “advocate” doesn’t mean “be rude.” I understand a little rudeness – you’re stressed! you’re coping! – but please try to be a polite advocate.

3) Asking questions is good. It may annoy some  nurses, but it’s a good chance for education. I find it helpful to be asked questions. And sometimes, that can help nurses catch things that otherwise would slip through the cracks. There are a lot of people working in medicine; people make mistakes; questions help catch mistakes.

4) There are some things where you do have to step back and let nurses do their jobs. For example, and every case is different, getting a patient up to the bathroom. We really don’t want patients to fall, and we don’t want family members breaking their backs. So let us help them get up to the bathroom.

5) Be patient. Healthcare is an enormous affair and lots of different people are involved – doctors, nurses, aides, respiratory therapists, nutritionists, chaplains. We really are trying to put your family member, the patient, first. That means you may have to tell the story a few times to several different people just so we all get on the same page.

6) Lay aside your professional status (doctor, nurse, lawyer) and be a family member. Sure, if you as a professional know that something is wrong, speak up. It shouldn’t be used to intimidate people. Rapport and camraderie are important in the teamwork setting of healthcare.
As for nurses, it’s really important for us to remember that every patient is someone’s loved one. A wise nurse aide once told me, “Treat all the ladies like they’re someone’s grandma and you’ll be fine.” Also, we are meant to be patient’s advocates, and if they don’t have a family member to help advocate, we need to pick up the slack.

Hopefully the nurses taking care of my loved one will treat her like I would treat their loved one; with the utmost care, respect, and patience. Hopefully they will understand if I call the nursing station tonight to check on her and ask a few questions. We do what we do because we care, both as family members and as nurses.

Get well soon!

5 Fun Ways to Make Your Rank List

It’s that time of year for 4th year medical students: rank list submission time. You see, medical students don’t get to pick their residency so much as they get to enter a raffle. They know they are probably going to get a residency, and residencies know that they will get students. Students rank the programs they interview at, programs rank their interviewees, and a computer makes the connections – known as the Match –  in March. The results are announced this year on March 15.

You can imagine how much fun this is for medical students who have pretty much controlled their entire lives with their minds and decisions… suddenly, not so much agency! I would think it was a cruel psychological experiment but it’s been going on for 30+ years and seems to be working.

Often, students know exactly which program is at the top of their rank list and which are at the bottom. But sometimes all the options are good and it’s hard to pick. Sometimes, you just need to figure out the middle order. Here are some ways you could use to make your rank list.

1) The MATSH  Method (like Match, get it?):  If you were ever a seventh grade girl, you probably played MASH. Mansion, Apartment, Shack, House. (The T stands for Tree house in our version). For our 2 rounds of MATSH we used the categories of “Residency,” “Type of Fellowship,” “Where to Live Long-term,” “What kind of dog to get,” “Where to vacation,” and “How many children to have.” Apparently we are going to vacation in Mexico, have 1 child, own a labrador, and Chris will do a C-section fellowship.

In other versions, we’ll have 18 children and own a capybara… I guess we’ll see!

2) Magic 8 Ball Method: I used my iPhone Magic 8-Ball app and we kept shaking it while asking “What about X residency?” However we got bored of this quickly as we came up with a lot of “Ask again later” responses and not enough residencies were getting eliminated. (I think of it as a modern day Urim and Thummim, although apparently not as effective).

3) The Polling Method: We didn’t try this but I kinda wanted to post a poll on facebook and see where people thought we should go. We had informal polls going of course but mostly people seemed to vote for the place farthest from where they lived… interesting… 😉 Just kidding!!!

But I think it is hard to get an unbiased response on “where do you think we should go?” I think it’s hard to say, “I’d like you here and yet… I think you should probably go FAR, FAR AWAY.”

4) The Random Bible Verse Method: I tried this with my Bible application on my iPhone and I got John 14:6, “I am the way, and the truth, and the life. No one comes to the Father except through me.” Very true but not exactly what I was looking for. But God works in other ways…

5) The Pros/Cons and Prayer Combined Method: This method worked for us. Chris looked through all the program information and we worked on a comprehensive pros/cons list for our top five. Then we prayed for discernment and guidance, and began to feel more and more settled in our decision over the weekend.

Of course just because we have our rank list doesn’t mean that it will happen like we think. But we are feeling a lot of peace about our decision. Thanks to all of our friends and family who have supported us through this whole process. You are the best! The great thing is that all of our choices are good and we are going to be happy wherever we end up.

I for one am excited about the next step. I know residency will be tough but hopefully God will give me the strength and guidance to be a good support for Chris during the rigors of residency and whatever other challenges lie before us.