Shania Lynn
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medicine

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

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

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