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It’s one of those ‘under the breath’ hush-hush topics that is usually only discussed in the break room or behind closed doors. The dating scene incorporation with the working scene. We all have come across it, heck some of us may have even tried it! Do you reckon cupid has a house at work?

I mean, it’s not like we don’t have lives outside of work (right?). OK, maybe some of us do? Okay, okay…maybe some of us try! The fact of the matter is, we spend a lot of time working side-by-side with the same people. And given the right set of circumstances, and the right set of interests, that really cool co-worker you like to work with may possibly develop into a upset more.

We all know  and work with nurses who are in relationships with other health care professionals. *cough *cough* (I’m married to a nurse). Is it right? Is it incorrect? Why? Why not?

What if things go incorrect?

I, for one, have never had a workplace romance as a nurse. I had a few failed workplace dates in my before pre-nursing life, though. And, well since they were failures it made the workplace a tad uncomfortable. I use the word tad loosely for anyone who has walked in those shoes before. Stress levels are terrible enough at work, do you really reckon you need that ‘ex’ crossing your path multiple times during your day? They are referred to as an ‘ex’ for a reason. And at work there is no escape sometimes.

I would say this is the major reason for being careful when deciding if this date/ romance is a upset you want to explore with your co-worker. If it doesn’t work out, how are you two going to handle the end-game when you’re both at work. That cool working relationship will be gone – jus’ sayin’. It’s food for thought.

But then again, what if things go right??

Now on the flip side of that coin, my wife and I have worked side by side. I reckon a couple can have a splendid working relationship as long as they keep it professional and respectful. There is no need to be calling each other pet names during the shift. Seriously. Oh, and the PDA (public displays of affection) – yeah that’s a huge no-no. Remember, keep it professional. You’re not at home or out at a restaurant, you’re at work.

Oh, then there is the whole delegation of authority come forth. Except you are both holding the same rank in the greater scheme of things, this will certainly become a insightful subject both in and out of work. When you and your noteworthy other are having a ‘disagreeing’ moment – how are you going to handle giving or taking orders from them? Hmm, just more food for thought.

Oh, and one last piece to this puzzle. The last time I checked most facilities have a policy that addresses this very thing. In most cases you can’t work in the same department, although there are exceptions. I reckon these policies are in house to safeguard from any of the above ‘difficulties’ I have mentioned. If you start that romance, is he/she worth leaving your department?

Does cupid have a house at work? Both scenarios are workable, but I reckon it boils down to what will change if cupid shows up (or disappears for that matter!). Can you live with those changes?

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As a young college student working at the community university bar, I encountered many miserable customers. A few were sober, most were drunk and some were just downright rude. Unfortunately, my testosterone and ego always got the best of me. The getting larger confrontation always culminated into a screaming match of who may possibly scream louder and who may possibly scream the longest. It didn’t matter who was right. It only mattered who won.

My, how things have changed.

I’m a lil’ grown-up now (*cough*cough*–I stress only a lil’ grown-up!). The bar I work in is called a hospital. My customers (both internal and external) come from many walks of life–everyone from patients to patients’ families, friends, coworkers, unit secretaries, allied health care professionals or product representatives, just to name a few.

I still have to deal with getting larger confrontations.

I still have no thought who is right or incorrect (sometimes).

The difference is how I act and react to these situations. I still have my bravado, my testosterone and my ego with me (shh–don’t tell anyone), but I don’t use them to try to “win.”

I can be grateful a highly-educated, skilled and seasoned nurse for passing on one of the best pieces of advice I ever received in my first 18 months as a nurse. I’ve since named it the “whisper reflex.”

If you ever want to de-escalate an irate, upset and angered “customer,” use the whisper reflex.

De-escalation is the quickest way to resolve nearly all issues of confrontation and conflict. No one can reckon straight, act rationally or make signal decisions in the heat of rage and uncontrolled emotion.

The next time someone is acting like a blow-hard towards you–regardless of why, what, when, where or who–use the whisper reflex. It’s exactly what the name says.

When it’s your turn to answer or defend your stance, use the lowest volume voice you can muster. You don’t have to change the tone of your voice, just the volume. If you consider screaming to be a level 10, respond to their scream at a level 1. Just loud enough that they can hear you.

I promise you, after a couple moments of confusion and outright disgust, they will figure out that their screaming is getting them nowhere.

While I’m here to tell you it works, it takes a lot of self-control and practice to be the person responsibility the whispering!

Let me know if you have ever tried this and share your experience if you have!

http://scrubsmag.com/quick-and-dirty-guide-for-nurses-caught-in-a-conflict/

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In this day and age, terrorism, bioterrorism, hazardous material and disasters have become ordinary nomenclature to all of us. As nurses and health care professionals, it’s our job to “be there” when it matters. We often are called upon during some of the most stressful times of our patients’ lives, but in the face of a disaster, there is no such thing as being “ready.”

Disaster preparedness shouldn’t be a foreign thought to nurses. Over the past decade or so, those “rare” and catastrophic events we normally would read about in our history books are now a part of our present culture. 9/11, bomb threats, anthrax attacks and frequent natural disasters have forced us to redefine what is considered “rare.”

So we as health care professionals have to approach these disasters with an open mind and start to mitigate the possibility that we are not exempt by being prepared.

I’m sure everyone remembers their hospital orientation (that was fun, huh?). Well, there is some vital information given during those long days that will help you navigate your way through a disaster, whether you’re on the clock or not. Here are some resources to keep in mind when it comes to disaster preparedness:

Know your codes

• Every disaster is “coded.” I reckon we all are familiar with the codes for patient distress or patient arrest. There are codes for natural disasters, though, as well as unnatural disasters.

If you don’t know your codes, know where to find them

• I, for one, have a dandy of a time remembering all the codes. Most of them are color-coded, but I’m not going to remember 13 different colors and their linked codes. Most facilities give you a detachable reference card that conveniently fits on the reverse side of your name badge. Use it!

Know where to find your resources

• Most facilities have gone digital, so your disaster preparedness plot may very well be online. Some are on the intranet, while others may be on excellent ancient paper. Just be sure you know where to find it.

Know your role

• During just about every disaster, each employee has a specific role–some are as simple as manning a doorway, while others will be as complex as safely moving patients. Your role may be further defined by your department as well as whether you are in a managerial position. Be sure you know what is probable of you.

Practice makes you prepared, not perfect

• Remember your first code? Subsequent codes didn’t get “simpler”–you became more knowledgeable and your skills were sharpened with each experience. Transfer that habit to disaster preparedness.

As always, my list is basic and simple. The more you know, the safer you are. The safer you are, the safer your patients and your loved ones will be. And who doesn’t want that?

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I’ve previously mentioned that, as health care professionals, we are never really “off the clock.” Some health care professionals have learned the hard way that being “unprofessional” can have dire consequences.

As a nurse, I’ve become socially gun-shy. Many of my coworkers have questioned me on numerous occasions to join them in an array of social activities ranging from drinks at the community “watering hole” to attending parties or vital events. I’ve continually declined their kind offers simply out of a dread of having too much fun.

Does that make any sense at all?!

The public has not been kind to many professionals who “let their hair down” and had a excellent time. Somehow the public equates our clinical skills and choice-making abilities with whether or not we act in view of that. A professional would never partake in loud or obnoxious behavior, nor would they consume alcohol of any kind. To do so would tarnish their reputation as a professional, right?

No one ever mentions that they are grown adults celebrating and enjoying the company of their family, friends and/or coworkers in a safe, non-threatening, non-violent and non-disrupting manner.

I’m willing to bet a few rotten apples have spoiled the bushel. Some extreme cases of carelessness, recklessness and juvenile behavior have raised the public’s concern.

In the end, I have spent a lot of time, effort and money to attain my professional position and degree. Am I wanting to go out and act like a fool? Or break the law? No.

Unfortunately, I’m still a tad bit defensive about interpretation. An innocent misinterpretation can be a very sharp sword. The mere presence of questioning one’s professional abilities simply because of what someone “thought” they saw is enough to hurt a career.

Whether accurate or not, perception is actuality. And with enough shape it can change other people’s perceptions.

I guess I’m not willing to risk all my hard work over a misinterpretation.

Am I being extreme? Or am I being conscientious? Anyone else courageous enough to admit to sharing my fears?

Maybe I’m just getting ancient? (Insert sarcastic smile.)

http://scrubsmag.com/can-nurses-have-fun-without-risking-it-all/

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Ever heard of the “15-minute rule” within the academic ranks? I first heard of it as a college freshman during an introductory physics class. The professor was late–the class started at 1:00 pm and it was nearly 10 minutes past the hour. I overheard a fellow classmate whispering to another classmate, “Five more minutes and we’re outta here!”

Of course, I had to know what they were referring to. They told me that the “cancellation courtesy” time was 15 minutes. If a professor did not show within that time frame, class was cancelled.

Whah??!!

Curiously enough, I heard this same urban legend throughout my college years. I cannot confirm or deny its validity, but it sure gave the newbie college students an excuse to ditch class, didn’t it?

So what does this have to do with nursing? I’m wondering if there is a “courtesy” time frame when awaiting a return phone call from a licensed provider who was contacted by pager?

Oh, you know what I’m referring to! You have an urgent (maybe even emergency) matter that needs addressing. You page the provider on call. And you wait for them to call you back…

Waiting…

…

Waiting…

…

Now, over the years I’ve heard many theories and contingency plans, but there is no documented standard the last time I checked (although I have heard of tentative protocols before). Some of the most aggressive nurses may wait five minutes if you’re lucky, while the more laid-back, nonchalant nurses have been known to house one page for the entire shift, whether or not they get a call back.

Is there such a thing as waiting too long? Or not waiting long enough?

It also seems to be dependent not only on the information you need to share, but also with whom you need to share it. With some providers you can get immediate calls back. Others claim the pager didn’t work, or that the full number didn’t go through. Walking on eggshells is a kind way to describe this debacle.

Then there is the sticky situation of no return call. What do you do when the situation needs addressing? Do you page them incessantly? Do you call them at home? Do you contact administration?

The actuality is, each nurse has his or her own plot of attack. I know we all have our patients’ best interests in mind, and ultimately we will do whatever it takes to address our concerns–even if that earnings sending out a search party for the provider in question (by the way, that’s a right tale!).

This is just another entry to add to the “things they don’t teach you in nursing school” list.

Care to weigh in?

http://scrubsmag.com/there-is-no-15-minute-rule-in-nursing/

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That got your attention, didn’t it!? Now, before you glide off the handle, let me clarify.

As nurses, our job is to improve the patient’s current health situation. We impact lives by delivering interventions that make the most of health and wellness. These interventions often are some of the most hard things a patient’s ever done.

I’ve said it time and time again, but everything we do has a purpose. Nurses don’t do a upset simply because it seems like a excellent thought. Our nursing practice is based on signal prove that has been researched and proven effectual in improving patients’ health situations.

For instance, after surgery, we don’t have patients breathe into those amusing plastic devices (incentive spirometer or flutter valve) just to see them turn blue in the face. Nor do we do it because we like to watch them choke on phlegm.

No, we do it to help fight and prevent pneumonia. Increased lung extension will help deter atelectasis (lung collapse) as well as go, mobilize and take out a lot of lung secretions. All of which are a excellent thing.

Along the same train of thought, early mobilization and continued mobilization also has been proven to decrease post operative pneumonia and decrease loss of corporal strength and function. The sooner and more often you go, the better.

I don’t get patients out of bed, into a chair and then ambulate them nearly the room and unit just to see them writhe in pain. I do it because I know it’s best for their health. It’s getting them one step closer to going home. And it will get them out of the hospital that much sooner.

I hope my patients despise me. I’d rather they despise me for responsibility my job of getting them better…..than like me for ignoring them, letting them take a nap all day and watching their health decline.

If you despise me, I must be responsibility a upset right.

P.S.–take this post with a hint of sarcasm. I don’t want any of my patients to truly despise me. I like to call it a small bit of “tough like.”

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We clean everything we can get our hands on, but we still get sick. While cleaning everything be splendid for fighting off those nasty bugs that can wreak havoc on your immune system, there really is some truth to the saying, “Too much of a excellent thing is terrible.”

Here are the top ten reasons why nurses get sick:

1. Not Washing Our Hands

We sure don’t practice what we preach all the time do we? C’mon admit it. Do you wash your hands every single time you go in and out of every patient room? Before and after every contact?

Also, are you washing your hands after each contact with a patients chart? How about the bedside glucometer?

2. Not Enough Take a nap

Research has proven that take a nap deprivation will lower your immune system. But, even without research on my side, reckon about how you and your body felt after not sleeping well for just one nighttime! How about a whole string of nights during the week?

3. Too Much Work

Go right ahead and work those extra shifts. While your paycheck is inflating, your energy reserve is deflating. Guess what happens to your immune system when you get run down? Hey, don’t get me incorrect, I like the overtime as much as the next nurse, but there has to be a balance between the extra shifts and taking care of yourself.

4. Not Drinking Enough Fluids

Who has time to drink? Well, non of us do, but can you say Urinary Tract Infection? I don’t know about you, but when your body is made up of more water than any other molecule (upwards of 65% water), that earnings a upset don’t you reckon?

5. Not Cleaning Our Stethoscope

This goes hand-in-hand with the hand washing, yes that was an intentional pun. Reckon about all the times you use your stethoscope and not clean it in between each patient use. Ever let someone else borrow your stethoscope? Where do you reckon their hands were? Did they clean the stethoscope? Did they wash their hands?

6. Using One Pen For All Our Patients

So you go into a patients room who is in precautions. Or better yet, it’s not your patient, but the patient is on your unit. Is there a dedicated writing contrivance in the room? What about a marker? I already know there is usually a stethoscope in there!

7. Being Too Clean

This ranks up there with Antibiotic Resistance, and prescribing an antibiotic for the flu. We nurses can be very clean, tidy and super-clean freaks. We take cleaning to a new level sometimes. We wipe down all surfaces before our shift starts, including the mouse for the computer, the telephone, the cupboards, etc. We clean everything we can get our hands on. While this can be splendid for fighting off those nasty bugs that can wreak havoc on your immune system, there really is some truth to the saying, “Too much of a excellent thing is terrible”.

If you ‘sanitize’ everything, what in the world is your immune system going to do when it really has to work and fight off an infection??

8. Allowing Too Much Stress

Don’t let the ‘man’ get you down. There are a million-and-one things out there we cannot control and only a handful of things we can. Somehow we always concentrate on what is out of our control and we run it through our minds over and over again, until it turns hideous. Stress is a amusing thing. It’s the one thing that if utilized correctly can help you break through some of the toughest obstacles, but if utilized too much or let it over-run your thoughts and your day after day life will severely affect everything that matters in a negative way.

Oh – did I mention that too much stress also lowers your immune system?

9. A Nighttime Out On The Town

Say it with me – ‘binge drinking’. No I’m not talking about the drunk fog from your collegiate years. I’m talking about that one nighttime you FINALLY get to hang out with your favorite crowd. You know, that one nighttime when the planets serendipitously align and all parties have the same nighttime off! Regardless of the day of the week, you all go out for a nighttime of fun. Fun with a capital F! A nighttime full of greed to the max, which includes some form of alcoholic substance. The only problem is you don’t know when to stop. So the drinking commences to the point where maybe parts of the nighttime are a lil hazy.

The next morning, or a couple days later you start to get the sniffles, and the body aches. You have no thought where you got this cold? Not only does the increased quantity of alcohol dampen your immune system, but guess what? Just imagine all the surfaces you touched, and all the hand washing you did not do while you were out partying? ‘Nuff said.

10. Arrogant Ignorance.

This goes for anyone who thinks they don’t belong in the same category as the rest of the public because you’re a nurse, because you ‘know better.’ You reckon since you are exposed to the ‘nasty’ bugs at work, there is NO WAY you’ll get the ordinary head cold, or upper respiratory infection, or the seasonal flu!

I’m here to tell you that ignorance is not bliss ladies and gentlemen.

Did I miss any??

http://scrubsmag.com/top-10-reasons-why-nurses-get-sick/

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So I know when you read the title all you may possibly reckon about was ‘what is it??!’ Anyone who is a nurse or on their way to being a nurse can use this piece of advice!

We live in the world of life and death. I don’t reckon anyone will argue with me on that. We can have many levels of definition when we are questioned what a ‘terrible day’ really is. In the end, we shoulder a lot of responsibility caring for our patients, and we sure don’t want to make ‘that one mistake’.We’ve all made mistakes. I know I have. Some tiny, some splendid, some breath-taking, and some are quite comical. At the end of the day we are all human right? Aren’t we entitle to tripping up once in a while?

I reckon it has a lot to do with HOW we learned of our mistake sometimes that can determine how that mistake impacts us. In nursing school I remember a patient of mine having an IV site come forth. The nurse caring for him did some adjustments to his IV site. While addressing the IV, she raised the bed up high enough to be close to waist-height (more than likely to lessen the strain on her back while troubleshooting). That particular day it was my huge day to hang my first IV. I got to prime the tubing, lock it into the IV pump and then attach it to the patient (I reckon we all remember that first time). I was nervous as all get out. I had followed the steps prior to entering the room. I rehearsed them in my head before I approached the IV pump. I check and triple checked the tubing. Reviewed the 7 rights, etc., etc.

I successfully hung the med and had it infusing properly with no alarms and no messes! When I was getting read to leave the patients bedside, my nursing instructor questioned if I forgot anything? Silently in my head I panicked and retraced all my steps four more times. Check, check, re-check.

I paused before answering no, that everything was fine.

The nursing instructor questioned me a second time. I re-traced my steps, 4 more checks over my work. I answered again with an ‘Aye-oh-OK’ response.

This dialogue happened two more times before the patient irrevocably looked over at me and kindly (and jokingly) said, “She’s obviously trying to tell ya a upset”.

I still for the life of me couldn’t figure it out??

My instructor kindly answers, “Well, excellent job on the IV, but if Mr. Smith wants to get out of bed to use the restroom or anything else he’s going to have to jump (and maybe fall).”

I looked at the bed – and it was still at waist-height! I got so involved in my task that I forgot that the nurse had raised his bed for that IV site troubleshoot!

I was mortified. I had missed a upset so basic, so simple, yet SO very vital. To this day I tell that tale to any and all that will listen. I have never left my patient’s bed at an unsafe height. Every time I leave my patient’s room I always, always, always lower the bed to its lowest setting. The way I learned that lesson has remained engrained in my brain.

I’ve made many more mistakes since then. Some even more comical, and some down right scary. I once entered in the incorrect infusion settings for a narcotic medication for a patient. I transposed concentration and total quantity of drug settings on the IV pump. Lets just say, thankfully the patient was intubated and the mistake was found quickly.

So back to my original statement : What is the one mistake every nurse shouldn’t make??

The mistake that they do not gather from.

Learning from your mistakes is the single most vital process of growing and maturing as a practitioner. Not learning from a mistake will set you up to make that same mistake again.

Be sure to gather from all your mistakes, no matter how splendid or tiny, your patients will be grateful you for it.

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I remember when I was first starting nursing school. Whenever the pesky small word math was mentioned, it struck dread into virtually the entire classroom.

I quickly found out that math is not a nurse’s friend. I’m not sure why, it’s just been a very well loved theme ever since that day and continues to be quite the conundrum. Nurses don’t like math. In fact, they loathe it.

Now, don’t get me incorrect. There are a select few out there that like and (gasp) may even like math, but they are few and far between. I happen to be one of them.

This infinite hatred is what confuses me to no end. How can nurses and mathematics not get along? I’m not talking calculus, differential equations or other advanced mathematics–I am referring to basic algebra. The actuality is, nurses need and use math every single day in one way, shape or form.

The basic nursing student must gather how to convert units of measurement, multiply fractions and calculate volume percentages. The entry-level new grad and eventual personnel nurse must utilize weight-based infusion rates and lab value nomograms. The bachelor’s and master’s nurse must gather to calculate numerous statistical analyses as well as exponential assess of predictive values for evidenced-based theory and management (the p-value is your friend).

As you can see, the math requirement goes on and on (do I even have to mention the quantity of mathematics a CRNA must perform?).

The truth of the matter is, math never, ever, ever leaves a nurse’s repertoire. You may use it less or more depending on your choice of work environment and career path, but it will always be there.

The take home message here, folks? If you are a would-be, want-to-be, or soon-to-be nurse… you better know your math.

http://scrubsmag.com/dear-nursing-students-know-your-math/

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Too often, we nurses dwell on everything that is going incorrect. How about (for once!) we imagine our world as perfect as possible? Here’s what I would have in my perfect nursing world:

• I’d never get pulled to work in another unit.
• Conscription would never be lacking.
• Patients would not be repeat offenders (admissions).
• Patient families would be amicable.
• Supplies would never run small.
• Pay rate would be generous.
• Changing jobs would be simple.
• All patients would have control of bowel and bladder.
• All patients would be pain-free.
• All patients would have five or fewer medications
• CT/X-ray/ultrasound apparatus would always be open and available.
• CT/X-ray/ultrasound apparatus would only be across the hall, not on the other side of the hospital.
• The elevator would open quickly every time you need it (mainly during patient transport!).
• Unknown would be confused or delirious.
• All patients would be compliant and believer.
• Physicians would not be passive-aggressive.
• Physicians would round on their patients all at predicted/scheduled times.
• Families would be present whenever a physician is on the floor.
• Nighttime shifts would not exist.
• There would be no once a year  job/employer competencies.
• CEUs would all be free of charge.
• CEU conferences would all be free charge.
• License rekindling would be free of charge.
• All nurses, all units, all floors and all coworkers would get along and work collectively as a team.
• Bodily fluids would not smell.
• Blood–more specifically, GI bleeds–would not smell.
• IVs would never infiltrate.
• IV starts would only take one try.
• IV fluids would never run out or run dry.
• All invasive lines and tubes would be properly placed every time, the first time.

This is a very small list–I know if I sat and really contemplated it, I may possibly quadruple it. I can dream, can’t I?!

Care to add to  the list?

http://scrubsmag.com/what-would-happen-in-a-nurses-perfect-world/