Shania Lynn
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patient stories

Nursing Tidbits: Insights from an Inpatient Nurse

January 10, 2022 by NurseTwain

Has anyone told you “don’t do it” or regret that they became a nurse?

  • Did you know that the national turnover rate currently is 8.8-37%, costing hospitals up to $56,000 per nurse according to NSI Nursing Solutions?
  • Nursing is a very stressful job especially in inpatient settings, however nothing is more fulfilling than pursuing your calling. It is important to focus on the “why’s” of becoming a nurse and keeping a list of positive patient stories, in order to remain at the bedside.

How long are actual nursing shifts?

  • Typically, 12 hour shifts. Actual times may vary, but most common is 7a-7p and 7p-7a. Actual clock in time is 6:45 a/pm and clock out is no earlier than 7:15 a/pm.
  • We get two 15 minute breaks and one 30 minute breaks. In reality, we are lucky to get a full 30 minute lunch.
  • My facility limits hours worked in a single shift to 16 hours.

Are raises common?

  • Many hospitals promote annual raises based on a yearly appraisal score. This is a point-based system in which rates performance and quality and then based on your score, your hourly rate will raise by a percentage.
  • Raises can also be given based on credentials. Oftentimes, a certification, higher degree, and more experience will pay more.

Do I have to be a bedside nurse?

  • There are many many nursing jobs that do not involve direct patient care. A nursing license can allow you to work in case management/ discharge planning, nurse educator, Quality, clinical nurse instructor, insurance companies, law firms, office jobs, and so many more!

Do I have to start on a medical floor?

  • I highly recommend beginning on a medical unit for your first year as a nurse. It is not required, but it is a great area to hone all of the skills you worked tirelessly for in nursing school. You also see a huge variety of different cases and learn time management skills.
  • It is not required, but starting out on a mother baby unit for instance will not allow you to perform certain nursing skills and you can lose them if you don’t use them!

How do I prevent burnout?

  • The most important way to prevent burnout and promote a healthy work-life balance is self-care. This can include exercise, a healthy diet, sleep, or any hobbies not medically related that you personally enjoy.
  • Overtime is great to an extent, but it is not something that you want to do every single week if you can avoid it.
  • If you notice you are overly anxious before a shift, connect with a mentor, your nurse educator, or even a licensed therapist to talk about your concerns. Sometimes, just talking to someone can do wonders!

What is something that surprised you about the hospital before clinical rotations?

  • I never had clinical experience in a hospital setting besides volunteering before I started nursing school. I was very naive when it came to actual patient care.
  • I was terrified to even take vital signs. I highly recommend a student nurse externship and tech position.
  • I had never seen a naked man prior to nursing school.. You can only imagine lol.
  • I didn’t realize people were placed in restraints if they became unruly.
  • I didn’t know bed alarms were a thing to prevent falls.
  • I didn’t even know we gave patients a bath in the hospital.. It makes sense, I just never though about it.

Do you have any patient stories that immediately stick out to you?

  • My first ever shot I gave was to a screaming elderly man in a nursing home.
  • I cared for a patient who had necrotic fingers.
  • My oncology patients are the ones I connect with the most.. I followed one lady from the time of her diagnosis until her death from multiple myeloma. We brought her downstairs to play the piano one time and I still watch the video her daughter shared with me.
  • The first hospice patient I ever cared for was also a man in his 50s with raging cancer. He was yellow and looked like a literal skeleton. He and his family were so kind. After he died, his daughters showed me what he looked like prior and he looked like a completely different person. I went home and cried that night.
  • My worst Covid case was a 60 year old woman. She was maxed on optiflow plus a nonrebreather. She kept saying how she didn’t want to be intubated and wished she got the vaccine. She was also so lonely, so I sat and talked with her for awhile. Later that night, we had to transfer her to a step down unit, during the transfer she crashed and her O2 was in the 40s. She was placed on bipap and recovered then, but she eventually died in the unit while intubated.
  • Most recently, I cared for a nurse in her 40s. She developed a psychosis after Covid and was a completely different person.. That one hit home.
  • SO many more…

Until next shift,

Shania

Filed Under: patient stories Tagged With: COVID19, hospital, medicalsurgical, medicine, nursing, nursingadvice, nursingfaqs, patient, patienttalk

The Great Resignation: Nurse PTSD

January 6, 2022 by NurseTwain

They say cardiovascular disease is the “silent killer”, but did you know that many nurses post Covid are suffering from the silent killer of PTSD?

During the peak of Covid, frontline staff were plunged into a plethora of uncertainty. No one knew what Covid was, how it effected the body, what the disease process was, what type of isolation was appropriate, etc. Then came concerns over PPE supply, vaccination status, and most recently, questionable CDC guidance. Nurses lived in a constant fight or flight response as they obsessively watched O2 monitors and prayed for an uneventful shift. The Delta variant proved to be brutal and rampant as more patients were intubated at bedside and transferred to the ICU than many of us saw in our whole nursing careers combined. These patients were so sick and everyone was so critical that nursing had to prioritize patients who were originally healthy and able-bodied, full codes, in order to preserve respiratory equipment as much as possible.

Crisis protocols were in place and meant that we reused single-use PPE and placed a 6L nasal cannula plus a nonrebreather on a patient because we didn’t have enough high flow cannulas. Allow these things to continue for nearly 2 years and now dealing with the third Covid variant, means that nurses are tired and burnt out.

Many nurses are leaving to travel and make more money for the same job duties, some are leaving the bedside and stepping into less stressful job positions, and others are retiring or even just leaving the profession for good.

The struggle we face as a facility and as a nation is critical staffing shortages. Patients will never stop flooding the ER, but what happens when we have no healthcare professionals to properly care for all of these people? More money and incentives are only temporary. A long-term solution involves staff retention and recruitment coupled with staff engagement and empowerment.

Until next shift,

Shania

Filed Under: patient stories Tagged With: COVID19, hospital, medicalsurgical, medicine, nurse, NursePTSD, nursing, patient, patienttalk, PTSD, staffing

‘Twas the night (shift) before Christmas

December 24, 2021 by NurseTwain

‘Twas the nightshift before Christmas, when all through the unit

All creatures were stirring, even at midnight.

The IV fluids were hung on the pole with care,

In hopes, the nurses would not wake the bear,

The patients once snug in their beds,

Now jumping over the rails, despite their meds.

And Betty Lou in her gown, and I with my mask,

Wrestling back to bed, proved quite the task.

Finally, back to the station, the nurses heard a clatter,

We sprang from our chairs to see what was the matter.

Into the next room, we flew in a flash

Tore open the curtain, and found the ash.

“You can’t smoke in this room, no!”

“If you don’t comply, then you may go.”

When, what to my wondering eyes should appear,

Five visitors wandering the halls… Oh dear.

Only 2 visitors allowed, I said quick.

No exceptions, the policy must stick.

The patients, we could not keep tame,

They whistled, shouted, and called us by name.

“Nurse! Nurse! Call the doctor,

Help me! Help me! I have fallen!

Get me up, 911 I call!

Now, leave me alone all!”

As personal dangers arise,

bilateral upper limb restraints, we had to tie.

So, the clock slowly drew

Us, nurses were quite tired, too.

And then, in a twinkling, we heard some shoes,

“Here, take some candy and chocolate as a thank you.”

As I drew in my head, and was turning around,

A bed was alarming all through the town.

A patient, undressed from his head to his foot

And, unfortunately, covered in what looked like soot.

Poop covered his back,

I no longer wanted my chocolate for a snack.

He just smiled and said to “Be Merry”.

Grinning from cheek to cheek, said his name was Larry.

We bathed and tucked him in, like so.

Maybe the night will settle, I hope.

It was Christmas, we reminded ourselves to seek.

A circle of urinals on the wall, we called a wreath.

Med-surg could be quite smelly,

But we did have treats that were filled with jelly.

Some of us dressed like elves,

Bringing some Christmas cheer into ourself.

The hours of 3-5am were always to dread.

Fighting sleep and simply dreaming of bed.

An IV beeping, going berserk.

Fluids and meds and tubing and stickers, back to work.

“Lab called about a critical, did you know?”

There is a do not call order in, MD chose.

30 more minutes… Come on, dayshift, Hustle!

Into my bed, I will soon nestle.

We gave report, and left out of sight.

“Happy Christmas to all, and to all a goodnight”

Filed Under: patient stories Tagged With: christmas, hospital, medicalsurgical, medicine, nightbeforechristmas, nightshift, nurse, nursing, patient, patienttalk, twasthenight

RN vs. LPN: What is the Difference?

December 10, 2021 by NurseTwain

Recently, my hospital has begun doing RN-LPN buddies. This is where the RN/LPN team can have upwards to 8 patients (normally a ratio of 1:6) or the LPN is split between two RNs with a higher acuity 6 patient group.

But, what exactly is the difference between the roles of an RN vs. those of an LPN?

LPNs also have options for certain skills certifications and there are several LPN-RN bridge programs.

The scope of practice for both RNs and LPNs also differs based on state of licensure and facility.

Until next shift,

Shania

Filed Under: patient stories Tagged With: lpn, medicalsurgical, medicine, nursing, Nursingschool, patient, patienttalk, RN

How I Became an RN with NO STUDENT DEBT: My Journey into Nursing

December 9, 2021 by NurseTwain

On average, a baccalaureate degree student accumulates $30,000 in debt and student debt is the second highest source of American debt, following mortgages (educationdata.org). The fear of debt, coupled with lack of motivation and other life endeavors makes it so difficult to obtain higher levels of education and more rewarding careers. Once one makes it into school, they are likely forced to quit their current job or severely restrict working hours to make time for the necessary studies, further accruing more financial strain.

I was very fortunate to have great advisors as I was finishing High School. I had a 4.0 GPA and was able to apply for and obtain many state grants. I was in the second round of students to receive the Tennessee Promise, which pays for 2 years of community college after receiving state funding. After receiving this information, I knew about a 2 year RN program at the local community college. It was a very intense 4-5 day program that allowed students to earn an Associates Degree in Nursing and become a Registered Nurse. With such a rigorous program, students could not work many hours. I was lucky to be able to continue to live with my parents and I did not have a family at the time, so this route was perfect for me.

I was accepted into the program shortly after graduating High School. Fast forward to February 2018 and I was a licensed RN working on a Medical-Surgical Unit.

The hospital also has a tuition reimbursement program with a 2 year post contract that I used to support my online 1 year Bachelor’s degree program. Within 3 years, I was a BSN- RN with no debt and happily working on a Med-Surg unit, while my High School friends were just then graduating and finding professional jobs.

It is worth the time and effort to research scholarships, find affordable and practical schools, and investigate the resources your workplace has available to you.

Until next shift,

Shania

Filed Under: patient stories Tagged With: BSN, medicalsurgical, medicine, NPD, nurse, nursing, Nursingschool, patient, patienttalk, RN

My anxiety got the best of me. Moments at the bedside.

December 2, 2021 by NurseTwain

According to the Anxiety and Depression Association of America, 18.1% of the US population suffers from anxiety, however only 36.9% of those people with anxiety seek treatment.

One of the many benefits of being a nurse is time spent at the bedside. The patients I remember most are those that I have found a connection with through talking to them. Along with educating them on their diagnosis or treatment, one of the most beneficial things we can do as nurses is to build a relationship… I know, I know easier said than done. We often feel like we don’t have enough time to connect with people, but it is in those moments that we can discover things. We may find out the reasons for their noncompliance, that it is their 50th wedding anniversary, that today is the anniversary of their daughter’s death, or even that they have no running water at home. Simply speaking to the person in the bed, making eye contact, and truly engaging in conversation, alone, can help relieve any fears that they may have and can also make for an easier shift.

Discovering like interests and creating conversation away from their hospital stay lightens up the room for both the patient and family. In a stressful situation, talking about things other than their current state can help divert their attention away from their pain and illness. We can make an impact by just being present with them in the moment and stepping away from our computers. Rapport is also a way to bring the humaneness of nursing back amidst the plethora of hospital protocols and technology scanners. Just like “skin is the nursing domain”, so is communication. Being transparent with patient and families is what they want and need. Keeping them up to date, while also connecting on a personal level can help alleviate any unnecessary worry in a less ideal environment.

Until next shift,

Shania

Filed Under: patient stories Tagged With: anxiety, hospital, medicalsurgical, medicine, mentalhealth, nurse, nursetwain, nursing, patient, patienttalk, talk

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