Wednesday, December 19, 2007

A LIttle Help for New Graduates

I certainly do not profess to be the expert here, but as a nurse for 23 years in med-surg, surgical progressive care, open heart, and ICU as well as a clinical nursing instructor and a graduate student (MSN), I think I have some general words of advice. So, for those of you who need it - here it is for what it is worth to you.

1. First - every time you sign your name as a RN - please remember how hard you worked for this accomplishment and the sacrifices of yourself and all those people in your life that helped you "make it!"
2. Remember, nursing is a hard job! It has always been a hard job and it will always be a hard job! (Florence Nightingale).
3. Learn as much as you can! Do NOT be afraid to ask questions. You might drive an experienced nurse crazy, but in the long run, any experienced nurse understands why you are asking the questions and will respect you for trying to build upon and grow your knowledge base. For those that don't - forget about 'em - they ain't worth the time of day and probably are burned out nasty nurses that need to get the hell out of the business.
4. Always remember - the only reason you are an RN is to care for that patient. They are the true reason our profession is here. Don't ever forget your compassion, honesty, love and integrity. Fight for that patient and the care they need - they are counting on you!
5. Never give a medication that you don't know how it works. Ask the "WHY" questions as many times as you need too until you feel you understand and are comfortable with WHY you are doing something. Too many nurses don't ask the "WHY" questions and that gets them into trouble.
6. Never let a physician intimidate you. Yes, they are more educated (in some cases) and have more experience than you do, but you are the person at the bedside that is best situated to see changes in condition. While in the beginning you might feel like you don't know enough - rely on other experienced nurses to review your assessment with. They will help you to determine what to say to the physician.
7. An employer will work you until you are dead! Live a balanced life and don't make excuses for having balance in your life. If they ask you to work extra and you know that your child has a play and you can't work - please know that NO can really mean NO! And, you don't need to feel guilty about it.
8. Don't get STUCK working in an area of nursing that you are not passionate about. It is the fastest way to burn out in this profession. Seek out learning opportunities that will grow your knowledge and skill in an area of nursing that you desire to work in. Nursing offers so much variety that there is really no reason to stay in a place that you are not happy working. And - don't let them tell you that you need a year of med-surg before you can go to a speciality area. While having a med-surg background offers you the opportunity to develop your skills and competencies - I have known many of nurses that went into a speciality areas right out of school and have been highly successful. It really all depends on your motivation and your commitment. You call the shots.
9. After you have finished your first year in nursing - pay it forward. Remember that poor new graduate that your manager just hired - help them, be friend them and mentor them. You owe it to them.
10. Remember that nursing is a life-long learning profession. No matter what happens in your life - keep learning and never forget the benefits of more education. And - finally, remember your days as a new graduate and be the experienced nurse that other new graduates can look too as a resource and a person to learn from.

Congratulations on passing your boards and becoming a nurse! We need you and we need you to stay around for a long time. Thank you for entering our noble profession and for making a REAL difference in the lives of patients that need your care and love. Thank you for caring.

Tuesday, December 18, 2007

Start the Conversation Today!

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Tell me what your thoughts are on this video!

Monday, December 17, 2007

Special Thank you!

Over the course of the last several months, I have diligently tried to get my blog up and running. I have visited some wonderful, wonderful blogs and I want to take the opportunity to extend some thanks out there to a few of my new blogger friends and those that I hope to become blogger friends with as well. To DisappearingJohn a word of thanks! Your blog has been great to read and your help to get me started has been invaluable. Keep writing and doing what you do - it is exciting to read the next saga for sure! Thanks also to Kim at emergiblog - while you don't know me from adam - I have totally enjoyed reading your blog and your links have helped me to learn more about how to manage this blog business. To Crystal at Nurse Pickle you are one of my first real visitors and that is exciting (Yes John - you were really the first, but Crystal came to the site without any provocation - at least I think).

And finally - a special thank you to all those bloggers listed in my favs! While I may not have linked you here - you are linked on my blog and I read you faithfully. At times, I may lurk not comment on what you have written, but I love the readings! Thanks to you all and I hope my blog will one day be as successful as yours!

PS - For Lisa at cargosarge your site has great meaning and I hope you continue to develop your blog. Many women have come home from Iraq with stories of their own and need a place to read, and post so they too can begin the slow and arduous process of healing. Your long range idea to provide a blog for these ladies is forward thinking and compassionate!

Friday, December 14, 2007

Impacting Lives!

This past week, I finished the fall semester with my clinical group. I have worked with these students both in the classroom, lab and now in the clinical arena for the entire semester. As a clinical instructor, I am not sure that you really ever realize the impact you have on a student until you see the difference in what they have become.

Case in point are my initial freshmen students. These folks (most of them) were as green as green can come. Each having their own background and their own personal reason for wanting to join the ranks as a registered nurse. My quest, to teach them how to become registered nurses.

As we entered the clinical environment, I came to realize that these guys and girls had a great deal of anxiety. I thought anxiety was good, because it keeps you on your toes and helps you to question everything, making a mistake a lot harder to come by. After the first rotation, I could see that these students were going to need to some hard love! That is what they got. Hard love. My expectation of their knowledge growth was predictable. They knew I wanted them to learn and they worked hard to do what was needed to demonstrate their growth.

As the semester ended this week and I held my last clinical day with these young men and women, I was thrilled to be a part and to witness their knowledge growth. They had finished out their first semester and were successful. Each had developed strength, confidence, but more importantly, their passion to care for people became stronger.

I salute you guys - you know who you are and say thank you for making this last semester one of my best!

They asked me to publish this "ODE" that I wrote them for their last day - so here is the "ODE" as requested.

An Ode to the
Student Nurse

Fundamentals, sciences and labs galore
I am a student nurse and I know there is lots more
I work and I slave to know all this stuff and
Go to the bedside and lose it fast enough!

The teacher, he’s great and helps me a lot,
But when he asks why, I stand there in shock

Does he not know, does he not care,
I am a nursing student and I am aware!
Ask me those questions, I’ll tell you I know
But the truth is, I am buried in oh no!

Room 235 and 236 are assigned to me,
teacher comes down the hall to tell me they are all in pee
Luis is shoutin, help me in here
The patient is squirting, it looks like yellow beer.

Todd comes a running with Amanda aside,
Paige and Landon have on their stride.
They’re working sir, exclaims Mike with a grin,
As he barrels past with the hairs on his chin.

Tammy’s a smiling, she got quite the laugh
As she sees all the students quickly run past.
She shouts Hey Teacher, you need me there too,
Only to find that her patient is blue.

Autonomic Dysreflexia she shouts to the crowd,
But she knew it already and was real proud!
Bravo to you and all of your cronnies,
The nurses love you and they are not phonies.

Stephanie just stands there gathering it all in,
Oh these silly students, she says with a grin.
They will all learn, they will all know
That nursing is something you pace as you go.
No running is needed and no shouting galore,
Simply walk to the patient and clean the pee up off the floor.

This class is almost over and it all about to end,
I know I’ve learned a lot and Teacher has been my friend
Today I sit and ponder the fate of my career,
I wonder to myself, was that really beer?

Friday, December 7, 2007

Thoughts - Reflection

So - I have returned to school to finish my Masters degree. Ultimately, I want to teach. That has been and continues to be a firm desire of mine. I think I have a great deal to offer new nursing students. I have been teaching in an adjunct capacity for sometime now. Interesting though, that every time I finish a degree in nursing, the requirements to teach on a full time basis seem to change right at the same time I finish school. It can be and often is very frustrating to me. While I recognize the need for faculty members to have advanced degrees, it is frustrating how the degree requirements change right at the same time as I finish my education.

Ok - here is my question - when I finish my MSN, will the requirements for teaching change again to the PhD level? Is it a bad thing to require more advanced education for nursing educators? No - not at all, but I really wish someone would clue me in the changes so I can be prepared rather than disappointed.

I will earn my PhD and then colleges and universities are going to be hard pressed to tell me that I am not qualified to teach.

Ok - enough about that!

I have not been on for a while and apologize to my devoted readers ( I think that totals about 2 people), but you are both very special to me and I am glad that you read my blog. I have really grown to love blogging and hope to spend a great deal more time doing this. Of course - right now I should either be at the gym, finishing (starting actually) my Christmas shopping, or doing my homework assignment, which is due tonight. But I'd rather be here.

I am going to begin a section in my blog for theory. As I finish my course work on nursing theorists, I have discovered that theory can be extremely interesting. Yes, the elements of theory are boring and some theories are simply boring as well. But, the more I read and discover nursing theory the more compelling I am to inquire further. I think there is such a need for effective theoretical framework as nurses navigate the health care maze these days. We need empirical information that will help us as nurses to advocate for our patients and get the care they need.

Patients enter and leave the health care system so fast that many of their chronic needs fall through the cracks. As nurses, we have an opportunity and an obligation to help these patients access care and serves that will promote a quality of life. As a nurse - I love the advanced technology of our time, but I hate the health care system. There needs to be major change if we are ever to help those that need our help the most. As the baby boomers age - the system will become more bogged down and access to health care more difficult for those that need it the most.

As nurses - are we powerless to voice our desire for effective change to the system? I DON'T THINK SO! We are the most powerful professional group in health care. Our numbers are staggering, if we would only come together with one STRONG, collective voice. Yelling - IT IS TIME FOR CHANGE! Are you going to join and become a member of the collective voice? Or, are you going to just sit back and watch the system devour patients? Interesting and thought provoking.

Monday, November 5, 2007

Tears in the Corner

I have to write today! I have to write because if I don't, I might be so profoundly sad that I will break down into a mess of tears. Not normal or even usual for me. My last two shifts were really tough. I admitted a guy that was in total manic crisis. Wow - it was horrible. All I could do is think about how terrible this must be for him. Flights of thought, picking at the walls and just generally not on this planet with us all.

Perhaps we are the ones that are not on the planet and "they" are the normal people. Ever wonder what they see? Do they know within themselves what is happening and are they totally powerless to control it? Wow - the mind - an amazing and yet very scary place.

Here he was - a beautiful, intelligent and obviously caring man - totally consumed by this terrible psychosis. There were no beds in the psych facility - he was going to be staying with us for a little while. Management of a manic is not an easy task, but it left me feeling profoundly sad as I cared for this man.

Maybe my emotional connection was related to how I see my middle son. He has this tendency and I hate that he has to live like this. It has impacted his entire life. He spends a lot of time consumed with making correct choices and doing the right thing. For most of us - these choices and decisions come very naturally, but for him - he has to work at it day after day after day! I love him very much - but there are days when he stretches my capacity at love. He tries though and he tries very hard to do the right things and make the right decisions. I am so proud of him, but he has a hard time knowing or maybe accepting that the people in his life know that he works hard at being a good human being.

Back to this patient. I had such a connection to him. Perhaps I felt his pain or had a higher level of empathy. Not sure, all I know is I felt for him. Not something I do very often as a nurse. Been in the field for too long to have direct feelings. I certainly feel for the newly diagnosed cancer patient or the patient dying, but this was different. Can't place my finger on it, but I know that these feelings helped me to have a higher level of compassion for the guy. I keep going back to how terrible this must be for him.

Maybe - just maybe he really does not even understand what he is doing. Even when he is managed, perhaps there is no recognition of his profile. His family is devoted and they were at his bedside as much as they could be. Do we enable these people? Enable them by accepting their inability to make better choices? Enable them by saying it is ok to have 15 jobs a year or worse yet - have no job and live off the family? Is this really enabling or is this allowing a disabled person the ability to have a home and a place to rest his head? I can't answer that. Half of me wants to say we probably enable far too much, but the logical part of me says that if they are disabled and can't hold a job - we have to help. What am I going to do if I find myself in this situation with my son? Let him sleep on the streets? Probably not, but will I be enabling him or helping him?

Profoundly different for me to have been impacted like this and to have just curious thought about a patent's condition. I'll end with a note - what do you think? Have you ever been impacted by a patent's condition to such a point that is made you different?

Thursday, October 25, 2007

Nurses and Blogging - Oh My!

Ok - so I am trying really hard to get this blog thing going. I have spent hours on the intranet just looking for ways to improve my blog look and add some decent features. I still don't understand RSS feeds - but maybe some of my new friends can enlighten me. I think I have done ok so far in terms of getting my blog up and running.

I spent a lot of time today looking at blogs from other nurses. Wow - these are freakin awesome! I have enjoyed reading so many of them and lost track of time. I had a huge paper due today for my nursing leadership class on empowerment. Anyway - I stopped reading blogs for 2 hours and finished my paper. I love to write - so finishing the paper was pretty easy - it was dealing with the APA and references that drove me crazy!

On to my original train of thought - I am hoping that I will start to see some small increases in traffic to my blog. I visited several blogs that I LOVED! Please check out my list of BLOG Favs! Anyway - I posted a couple of comments and left the url to this blog. If you are stopping by - please leave a comment and say hi. And - for those bloggers stopping by because of a message I left - hey your blog was great!

Ok - much to do today and I want to post some more later. Have to work tomorrow - so need to get my posting on here as I have much to say today.

Monday, October 22, 2007

Graduate School

I realize today that my life has been and continues to be consumed with education. I knew that being a nurse would require that I keep pace with advancing technology and health care changes, but I guess I never realized that it would also take a life-time of education. Not that I am complaining - but it seems to me that the nursing education system really needs to do some work in order to retain my interest. After almost 11 years in school, it seems to me that I am caught in this maze of redundancy. What does this mean? It means that classes I have taken at lower educational levels seem to reappear over and over again as you progress through the educational system and earn advancing levels of education. How many times is it necessary to take Nursing and Families or health care populations? How many times does one have to take nursing research? Are these different courses than we have taken in our undergraduate degree? No - they are the same! Give me a nursing science course that has some meat and some NEW information to learn. Please don't give me the same old nursing jargon I have heard for years. Something new and exciting please. Perhaps that I why I am getting ready to earn my PhD - so I can develop some new theories and provide some meat and potatoe courses for nurses.

Has anyone else experienced this? Dose anyone really ever read these blogs? Perhaps I am writing this on an ever present cyber book that no one will ever see, read or care about. On the chance that someone really does read this or any other blog for that matter, I will continue my train of thought.

As I am investigating graduate schools for my doctorate in nursing research, I am challenged to find a system of higher learning that offers a unique and differing perspective for nurses. It seems like it is the same ole research question(s). Has anyone looked at the nursing educational system as a whole and developed a meta-analysis of how poorly organized nursing education is today? Do nurses themselves really care about how we are educating our future generation? Does it concern anyone that while nursing is a degreed profession - we are graduating nurses that are able to pass entrance licensing requirements, but fail to have the skills to function in the real world environment? Is anyone concerned that as these nurses enter the work force they are leaving as fast as they came in? Does it bother anyone that these men and women have invested time and money to earn their RN designation, only to discover that nursing is not unified and there is no real clear leadership or direction in our profession today? Does anyone really care about those that are caring for our citizens?

I care! I care a lot! I probably care more than I should. I care because I think that nurses are wonderful, intelligent and giving people. I have never run across a nurse who told me that he or she went into nursing because they could make good money. Nurses that I have worked, been in school with and have been in association with are those that have the heart and passion to care for those less fortunate. These are some real people!

Where am I going with this blog today? I guess I am trying to ask some hard questions. Do we properly prepare our nurses for practice? Do we give our new graduates the tools they need to be successful? Perhaps these are the questions I can use to develop my dissertation. Who knows - we will see!

Tuesday, October 2, 2007

Nurses - it is your time to speak! Share Your Story, Frustration or ray of hope!

Nurses - this blog is for you. For you! You can write and share things that are on your mind, ask questions, present empirical inquiry or simply tell a story. Had a particularly bad day at work - write and talk about it. Trust me - it can be very therapeutic! I know first hand and it really works for me.

This blog is not about judgement, rather - it is a safe place for nurses to come, kick off their tired nurse shoes and sit back and enjoy some good conversation with old friends, new friends and future friends. This indeed is your site to use as you wish.

Some basic rules - remember HIPPA and please do not post real names. We certainly want to protect the innocent.

Have at it - I am waiting for some really good activity on this blog.

Oh - and please don't forget to share this blog with your friends. Before you know it - we will have a nurse blogging community that is awesome!

Blog Growth

RNSpeak! continues to grow. Notice that several new links have been added to the site. The link to MedScape provides nurses with wonderful and exciting news on new research data for evidenced-based practice. In addition, I have had the wonderful opportunity to be introduced to Echelon Education. This site provides nurses with exceptional continuing education programs. For nurses in Florida - they have a specific program of study that provides for all of your requirement education for licensure renewal and it even transfers this information to CE Broker automatically. For nurses outside of Florida, the educational programs are wonderful for continued competency requirements. Take a moment to click on the links and spent some time exploring these new sites.

Please let me know what you think of the site as we grow. The only way I can make improvements and help RNSpeak! become the premiere nursing community is to hear from you.

Thursday, September 27, 2007

Nursing Organizations

I know many nurses that support the ANA (American Nurses Association) and other grass root types of organizations. But, I think I know more nurses that are simply not involved in nursing organizations. I am not a member today. I have held memberships in the past, but I am not a member today.

If I am asked why I don't hold membership to a national nursing organization - my answer is pretty simple. They lost me. Their issues are not issues I am passionate about. I work in education and I work at the bedside as an ICU nurse. Does the ANA have any clue what challenges I face each and everyday caring for patients at the bedside? Do they have a clue about issues I face as an educator in the nursing world? I don't think they do. For me - if I felt any connection with the ANA, even if it was a slight connection - my membership dues would be paid each year!

Ok - with that said - how accountable and responsible am I for the actions of the ANA or other professional organization that represents nurses? Very responsible. Because as a professional - I have a voice and my voice is important. I have a lot to say - so, they (the ANA, et al) need to listen to me. The little single nurse at the bedside and in the classroom.

ANA - are you around? Can you hear the little nurse? Do you care about us at all? Do you have a passion for our issues? Remember - our issues are the issues that impact the patient. Yes - the little nurse at the bedside has a lot to say - give us a forum and let us speak ... and listen and help us become united so we can make a difference for our patients. Listen very carefully - because we know the REAL issues and can communicate them very clearly. Unfortunately - the single nurse at the bedside has lost interest in the ANA because so many years have passed and no body listens to us. Perhaps it is time to give them a second chance. Or - maybe it is time for a real grassroots organization that represents the nurse at the bedside and can really help make a difference.

This is how grass root organizations start you know ... a single voice that unites many ... BAMMM - there is a new organization. Maybe it is time!

What do you think?

Sunday, September 23, 2007

Blog Under Construction!

Welcome to RNSpeak! This blog will be dedicated the issues that impact nurses in all health care environments. It is my hope that you find something of value and interest here. I will try to provide solid and strong links for nursing education, links on issues of nursing reform, associations and groups that promote advocacy!

I also will place a section of my favorite nursing blogs. Take the time to visit with some of my new friends.

A key characteristic of a great blog is discussion! So, with that thought in mind - please post, post and post. I hope that nurses from around the country have the opportunity to view this blog, subscribe to it and keep the action alive.

Bookmark and subscribe to this blog right now, because this blog is going to be one of the most popular blogs in nursing!

Thank you for stopping by. Please post a comment to this post indicating that you have been here. It does not have to be anything fancy - just something that says "hey - I was here."

RNSpeak!