Monthly Archive for May, 2009

Most Educational Nursing School Moments

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on May 28, 2009
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i_student_3Nursing school can seem like an endless labyrinth when you’re inside of it. Yet within months of graduating it may look like the tiniest of roads as it disappears in the rear view mirror. You are soon living in a surreal time period when you’re no longer a student nurse but not yet a registered nurse because you haven’t taken the NCLEX exam (I was a very medically knowledgeable hostess at Chili’s during this time).

This holding pattern gave me the chance to take my first real deep breath in four years and reflect on what I really learned during nursing school before jumping back into the pool again as an RN.

Here are the moments that stood out the most.

  1. Poker Face: During my very first clinical, sophomore year in a local nursing home, my clinical instructor reprimanded me for not having a proper “poker face” that nurses are apparently required to have. I guess I got the hang of it because years later, when I took an acting class my acting instructor told me that I had too much of a poker face and needed to learn to show emotion.
  2. STDs, Birth Control and Me: Part of my senior year community health clinical had me assigned to an urban halfway house. For reasons that I still can’t remember, for my senior year project I chose to give a presentation to the shelter women about sexually transmitted diseases and birth control.At that point in my life, I will admit that I didn’t have any first hand experience to report which made it all the more bizarre of a project decision. I’m pretty sure my face was a red hot radish throughout the entire lecture and I’m really not sure how much these women could possibly have learned from me. Although it was excellent practice for the myriad of often intimate patient teaching experiences I would later face as an RN.
  3. Ayuda Mi Dios: Watching the birth of a baby was the greatest moment of my nursing school experience. And watching the medical student catch the baby and hand it to me, was the most terrifying. The students in my class unofficially competed with one another about who got to see a birth first and then who got to see the most births. This was my only one and I was the last student in the class to witness a child birth.The semester had almost ended and I was losing hope that it would happen. In fact, during the previous clinical day I had stayed several hours past “quitting time” in hopes that my patient would deliver (she did – about a half hour after I left). The delivery I did see was fast. So fast that I wasn’t the only one surprised.The poor mom progressed so fast that medication was no longer an option and she had to deliver naturally. It was a loud, messy miracle, but a miracle nevertheless. There’s a part of me that will always associate the words “ayuda me dios” with childbirth – “Help me God.”

Nobody ever said miracles were painless, kind of like getting a nursing degree. Remember to pay attention to the little moments in your nursing school journey. Don’t wait until it’s in the rear view mirror before you start paying attention. You might miss something.

For the Math-o-phobic Nursing Students

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on May 22, 2009
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i_student_1I was already halfway down the hospital corridor to my patient’s room with a syringe full of IV Digoxin in my hand, when something stopped me. In past blogs I’ve mentioned a nurse’s infamous gut instinct when it comes to sensing that something isn’t right. Well, on this night, only a couple hours into my 7pm-7am overnight shift on the med-surg floor, my gut instinct kicked in and propelled me right back down the corridor to the nurse’s station.

I had calculated the Digoxin dosage by hand and also by calculator but my instinct was right. The decimal point was still in the wrong place. If I had pushed that amount of medicine directly into my patient’s vein, there’s a good chance that he would have gone into cardiac arrest.

Moral of the story for nursing students: The best calculators and computers will never replace good old-fashioned math skills and the human brain that processes them.

That night on the floor was ironic. I had earned straight A’s on all my medication dosage calculation tests during nursing schools (I wonder if they still teach nursing students to calculate dosages manually). In case you think I’m bragging, I’d like to point out that until nursing school my cumulative math score was somewhere around a C-.

I hated and feared math and all math related skills growing up. However, once I had conquered my initial math-o-phobic panic attack when faced with my first medication dosage test in nursing school, I had a revelation – math is fun when it’s applied to something you’re interested in.

As nursing students this is important advice to take to heart. If nursing is your chosen profession, do not allow fear of the known or unknown to detour you from your goals. Nursing school sometimes feels like an impossible amount of studying and coursework but you will get through it. The same is true for the nursing boards (which I will cover in a future blog). I transformed my fear of math into an interest and a respect for it. Rely on the technology available, but always remember my story of how a human brain that used to fear math, used it to save a life.

Nursing Skills Still Best Diagnostic Tool

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on May 19, 2009
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High Tech Tools Don’t Replace Eyes, Ears, Common Sense

i_nurse_female_3At the rapid rate that diagnostic testing technology is evolving, future generation of nursing students may be learning about a magic wand that reveals patient conditions before they even develop. Diagnostic tools that nurses and other practitioners use are concurrent with emerging needs of various patient populations.

For instance, there has been a cumulative rise in the number of severe traumatic head injuries such as the subdural hematoma that took the life of actress Natasha Richardson earlier this year. This type of data has led to the discovery of a certain serum protein biomarker that can detect serious brain injuries early.

Heart disease and the entire family of cardiac related disorders has always been a magnet for some of the most exciting advances medicine has to offer. This is a blessing indeed for the tens of millions of baby boomers who are entering old age with clogged arteries and ailing tickers from decades of fatty food abundance. Between learning how to interpret brain injury blood tests and staying current with patient teaching for the newest cardiac tests, nursing students almost have to become techno-geeks to keep up.

Stop. Before you go and immerse yourself in the technological side of patient care, make sure you don’t forget the human side. As a nursing student and later as a nurse, your most important diagnostic tools don’t require a battery, outlet or user’s manual. A nurse’s critically thinking mind, perceptive touch, alert eyes, and finely tuned ears are his or her most valuable diagnostic tools.

One of the dangers of the nursing shortage and replacing RNs with lesser trained health care providers is that RNs are trained to walk in a patient’s room, observe and detect the subtlest changes in a patient’s condition. Even after being trained to do this and then doing it several times, I find it difficult to explain how nurses are the best human diagnostic tools I’ve ever seen. As nursing students, it’s very important to be aware of these skills, nurture your natural assessment instincts and above all, learn to ask questions when you need to and trust your gut.

There was a great scene on the popular television show ER where the nurse turned medical student told her supervisor, when asked how she knew there was something more serious going on with her patient than what tests revealed: “He just didn’t look right.” How many computers can do that?

Male Nurses

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on May 11, 2009
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A Manly Profession Indeed

i_nurse_maleI’m not sure how to say this without coming off as sexist, so I implore you to hear this with an open mind. The small number of male nurses in my nursing school class and the ones I later worked with as an RN in the hospital were considered “token males” in a way. I can assure you that this was not intentional.

We “female nurses” actually put our male colleagues up on a pedestal of sorts. The men had a way of staying above all the politics, being everyone’s favorite co-worker, and being incredibly useful as lifting help and to help with combative patients. Again, I don’t mean to sound sexist. These were just some aspects of our working relationship, and ones that I valued.

The piece about helping with combative patients recently became debatable when ‘Statistic Canada’ reported that more male nurses (46%) than female nurses (34%) were assaulted in Canada during recent years. To be fair, the male nurses I worked with volunteered for combative patient duty as many times as they were drafted.

The difference between male nurses now and male nurses then is that they are now commonplace enough that only the media refers to them as “male nurses.” In the workplace they are nurses who are men. I’ve never heard “regular” nurses referred to as female nurses. A nurse is a nurse is a nurse.

Even with their numbers growing steadily, as of 2008 only 6% of the nursing workforce was comprised of men (American Nurses Association). At one time, it was cool for men in nursing whites to talk about their transition from working medical detail in the military to civilian life in hospitals. Others would broadcast that nursing was a stepping stone into medical school. This worked very well since many of their patients, especially the older ones, frequently thought they were doctors anyway. I’m sure those sweet little old ladies weren’t trying to be sexist either.

The current economic downturn and subsequent demand for nurses, especially RNs, has changed that. As men are being laid off from less stable careers, the stability of a career in nursing is becoming more attractive and definitely more lucrative. Myths and stereotypes aside, I would say to men considering a career in nursing that this is the best time to make the leap.

You are no longer considered a “male nurse”, you are no longer a novelty and therefore are on equal playing ground with your female counterparts. Above all, once you add the letters “RN” to your name it honestly doesn’t matter if your name is John or Joann. Just be careful of the little old lady with the left hook.

Preparing to Care for the Aging Population

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on May 3, 2009
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i_nurse_geriatrics_2America’s growing population of aging baby boomers means that as a nurse, you are likely to utilize some areas of health care knowledge more than others. The estimated 80 plus million aging baby boomers and older patients in general (65 years and older) face a targeted set of health problems unique to their age and heath history. A smart nursing student will anticipate the health care needs of this growing patient demographic and prepare to meet those needs as a nurse.

Medical research is finding that today’s baby boomers are sicker than the aging populations of the past (American Heart Association). This is a demographic of patients that will require intensive nursing care. Here are some specific specialty areas where baby boomers may require the most nursing care and expertise. The common denominator of this checklist appears to be abundance. Unlike their parents who survived the rations of depression and war, baby boomers have not wanted for anything, including an abundance of less than healthy foods.

Heart Attacks/Heart Disease: According to the CDC, more aging baby boomers are being hospitalized for heart attacks than patients the same age from previous generations. In fact, it is predicted that more baby boomers will face heart disease and its complications than any other condition by far. This means that more and more nurses will be needed who specialize in cardiac telemetry, who are trained to assist in cardiac procedures (such as in catheterization and angioplasty) and cardiology in general.

Diabetes: This has always been a major focus of nursing studies, particularly with its broad spectrum of multi-system complications, affecting everything from failing eyes to amputated toes. The same lifestyle factors that are causing the increase in heart disease are causing the same increase in the prevalence of diabetes in baby boomers.

Problems related to obesity: Speaking of those lifestyle factors, let’s not forget about the additional set of health problems resulting from obesity such as digestive system cancers, high blood pressure and stroke.  These are all excellent specialty areas for future nurses to focus their attention on.

Problems related to lack of health care coverage: Medical technology and the success rates of treatments are evolving in leaps and bounds. But what’s the point of all this progress if people don’t have access to health care? Lack of health care coverage, hospitals cutting back costs and the nursing shortage will inevitably be significant factors in caring for the aging baby boomers. Future nurses are likely to see an increase in advanced stages of preventable diseases, simply because people do not have access (or are not taking advantage of for financial reasons) to preventative health care. For these reasons, a foundation of solid patient teaching skills and public health knowledge is essential for today’s nursing students.

Their parents survived the great depression and world war. However the biggest challenge for baby boomers is not external at all, but rather their own bodies betraying them. Nursing students will be on the front lines of handling this and must start preparing now.