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patient stories

From Proficient to Novice

March 30, 2023 by NurseTwain

Dr. Patricia Benner created the nursing theory of knowledge progression ranging from novice to expert. She describes what it means to be an expert nurse and the step by step trajectory a typical nursing career follows.

Student nurses are novice nurses. New grads progress to advanced beginners after their preceptorships, orientation, and passing the NCLEX. The beginning stages of this theory revolve around building those initial nursing experiences for each different disease process. At the early stages, nurses are able to recognize abnormal findings, but may not be able to decide the appropriate interventions or recommendations to treat those issues. As they gain more experiences, review order sets, and recognize patterns, the nurse becomes competent. Several more years later, the nurse becomes proficient and can expect order sets for each finding. An expert nurse has many years of wisdom and experience to draw back on. They develop intuition, offer more creativity and alternative solutions, and seamlessly care for the whole person.

When I left the bedside, I classify myself as proficient. 5 years at the bedside allowed me to recognize orders, recommend interventions, and expect outcomes based on selected treatments. However, I am only proficient at the bedside. Once I moved into education full time, I am now a novice educator. I relate so much to my novice students in fears of the unknown and learning to be okay with discomfort.

There is so much to learn in each Individual field of nursing. Lecturing disease processes is so different than practicing it at the bedside.

I am a novice nurse again and that is okay.

Until next shift,

Shania

Filed Under: patient stories Tagged With: bedside, benner, education, hospital, medicine, nursing, patienttalk

“Your discharge is not priority”..

January 7, 2023 by NurseTwain

“Due to short staffing, we are closing early. Sorry for any inconvenience.”

“Please expect longer than usual wait times due to short staffing..”

“Now hiring. $15/hr starting pay.”

These signs and statements look all too familiar within today’s society. The nursing shortage has been ongoing for years and only getting worse. Short staffing at grocery stores or restaurants cause frustration and inconvenience. However, short staffing in healthcare is deadly and only increases the shortage as healthcare workers are overworked and burnt out.

It is really hard to be the nurse that we signed up to be…

  • When we can’t talk to our patients like we would like to and truly listen to them without having 1000 other urgent tasks to complete
  • When we don’t have time to brush our patient’s hair or give them a shower
  • When we don’t catch a dangerous trend in labs or vital signs because we are too busy to think
  • When we make a simple medication error because our phone keeps ringing or call lights are nonstop
  • When we don’t have the compassion we did as a new nurse..

As a nurse, we pledge an oath to do no harm, but it is very difficult when we do not have the resources we need to be successful and advocate for our patients as we should.

What doesn’t make sense either, is that administration views short staffing as doable, giving more and more patients to staff because they have to. But, are these overworked staff receiving additional pay? Most of us are not. The healthcare system does not operate on the usual economical supply and demand system. As demand rises, our pay does not increase.

From a patient standpoint, outcomes and satisfaction suffers. Healthcare worker violence rises and staffing is a major factor. Nurses must prioritize care, especially when having high-acuity loads and no help.

  • We must treat a low blood pressure before performing wound care.
  • We have to prevent a patient from falling before administering your home medication on your own schedule.
  • We will attend to a code before patient teaching.
  • We have to administer scheduled medications and/or pain medications, before printing discharge instructions.

Your discharge is not priority. We are literally saving lives and patients need to realize that a hospital is not a hotel.

I guarantee you, nurses are not just sitting at the station playing cards, drinking tea, or any other outrageous assumption made by the media. We are trying…

Until next shift,

Shania

Filed Under: patient stories, Uncategorized Tagged With: hospital, medicalsurgical, medicine, nursing, nursingshortage, patient, patienttalk, staffing

It’s okay to take up space

August 13, 2022 by NurseTwain

Do you ever say sorry out of habit? “I’m sorry for..”

Making it into the grocery line first

Being in the med room as another nurse walks in

Filing a valid complaint

Asking for a favor

Waking up a doctor for a patient need/concern

I have a habit of apologizing for things that 1.) are not my fault 2.) unintentionally inconveniencing others, 3.) allowing others needs to be greater than my own. In other words, I say “I’m sorry” for things that those words are not even intended for. The word “sorry” stems from a word meaning sorrow or sorrowful. Do I feel sorrow for any of the above scenarios? Of course, not.

While out wedding dress shopping for my sister, my sister was constantly apologizing for bringing more dresses into the dressing room or needing a different size, etc. Finally, the sales associate said, “you need to stop saying, ‘I’m sorry’. I told myself that I need to stop saying that because I am allowed to take up space.”

I am allowed to take up space. We should never let ourselves feel less than others. Apologizing for being a customer doesn’t even make sense! Also, we have learned over the years that empathy is way more affective than sympathy which the words ‘I’m sorry” go with. So, allow yourself to take up space in this world like the billions of other humans that walk the earth.

Until next shift,

Shania

Filed Under: Nursing tips, patient stories Tagged With: hospital, inspiration, medicalsurgical, medicine, nurse, nursing, patient, patienttalk, RN

Row, Row, Row Your Boat..

February 9, 2022 by NurseTwain

When we hear those first 5 words.. “Row Row Row your boat..”, we can’t help but finish the nursery rhyme, “gently down the stream, merrily merrily merrily merrily, life is but a dream.” This is simply a commonality that humans share with one another. In nursing, in order to connect with people, it is important to find that common knowledge that we both share to develop a healthy rapport. And sometimes, we must be creative to motivate our patients to do things that would benefit them.

We had an elderly man with dementia and we were rolling him in the bed to change his sheets. He just started singing “Row Row Row your boat” as he was rolling, and of course we all sang along with him. It is those small moments of laughter that can brighten our day along with our patient’s day.

Another time, a nurse began dancing with her elderly patient, just to get him to get out of the chair. They both had a good time!

Some other creative patient encounters included:

  • Bringing a patient to the main lobby to play the piano and sing
  • Wheeling a patient around the unit in a wheelchair to get them out of their room
  • Baptizing a patient in the chapel
  • We have married multiple patients in the hospital room
  • Sitting a patient at the nurses’ station because they didn’t want to be alone
  • And so many more!

All it takes is just a moment to make a connection.

Until next shift,

Shania

Filed Under: patient stories Tagged With: connection, medicalsurgical, medicine, nursing, patient, patienttalk

Being Grateful for the Little

January 25, 2022 by NurseTwain

. “… The foundation for greatness is honoring the small things of the present moment instead of pursuing the idea of greatness.” – Eckhart Tolle, A New Earth

Last night, I cared for a lady with covid who seemed very down when I first walked into the room. She remained on the phone with family as I tried to speak with her and give her her nighttime medications. I began to get frustrated because she was not acknowledging me as she continued to talk on the phone while I do my assessment. After she took her pills, I stepped out of the room and completed the rest of my med pass.

Throughout the night, I checked on her every couple of hours to make sure she didn’t need anything.

At the end of the shift, I rounded my last time and she asked me to bring her a piece of paper and to write down her care team for the night. I brought her the paper and she looked at me with tears in her eyes and said, “you are my favorite. You are the first person that has come in here to check on me multiple times.”

That broke my heart for a couple of reasons.. First, from our first impression, I was not going above and beyond to make her happy since we did not develop a connection due to the initial lack of mutual communication. I felt almost guilty because I shrugged off her persona since she wasn’t wanting to talk with me when I was in the room. Second, Something so simple as to walk into the room to check on a patient should not be so unheard of. This patient so greatly appreciated the human interaction that she wanted to recognize us for simply caring for her.

These covid patients are locked in their rooms for days and unable to see family. Oftentimes, nurses are the only people they physically see while they are in the hospital and it is at those encounters that we can provide the encouragement they need to get better.

Don’t forget the impact that little acts of care and kindness can bring.

Until next shift,

Shania

Filed Under: patient stories Tagged With: COVID19, hospital, medicalsurgical, medicine, nurse, nursing, patient, patientstories, patienttalk

All I want is a nap! The Importance of Sleep

January 19, 2022 by NurseTwain

Sleep is a resource that is given to us to promote natural immunity and healing throughout our bodies. It doesn’t just refuel us for a new day, but it also cleanses our bodies from harmful chemicals, promotes healing, allows increased learning and retention, and relieves stress. Such a powerful resource often gets pressed as the busy-ness of life increases. It is common for Americans to be okay with 4-6 hours of sleep because other activities take priority. But, how much damage is actually being done by chronically depriving ourselves of sleep?

  • WHO recommends 8 hours of sleep for adults per night. A very small percentage of the population can healthily survive on 6 hours, but you are more likely to get struck by lightning than have this gene.*
  • 2/3 of the adult population fail to get adequate sleep, creating a sleep epidemic.*
  • A full 8 hours is important because your bodies immune system acts on multiple REM cycles.*
  • Inadequate sleep leads to multiple medical conditions including cancer, Alzheimer’s, Diabetes, obesity, and so many more!*
  • In a study conducted in South Korea evaluating the effects of “shift work” or nightshift as we say in America, “65% of CCU nurses reported having trouble staying awake with 20% falling asleep at least once” and “inadequate sleep mimics a BAC of 0.5%- 1.0%” (Min, A. et. al, 2020).
  • Dr. Matthew Walker also explains that “after remaining awake for over 15 hours, you are as impaired as a person with a BAC of 0.08%, the legal drinking limit.”

These are just some statistics regarding the importance of sleep hygiene. After reading Matthew Walker’s, Why We Sleep, as well as, conducting my own sleep research, I always prioritize sleep and ensure I get my 8 hours. Prevention over treatment!!

Until next shift,

Shania

References:

Min, A., Hong, H. C., Son, S., & Lee, T. H. (2021). Alertness during working hours among eight‐hour rotating‐shift nurses: An observational study. Journal of Nursing Scholarship, 00, 1–8. https://doi.org/10.1111/jnu.12743–

*Walker, M. P. (2018). Why we sleep: Unlocking the power of sleep and dreams. Scribner, an imprint of Simon & Schuster, Inc.

Filed Under: patient stories Tagged With: MatthewWalker, medicalsurgical, medicine, nurse, nursing, patient, patienttalk, selfcare, sleep, Whywesleep

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