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nurse

The Meaning of a Pin

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Shania Lynn The Cure For The Common Read Photo As a student nurse, the one day that you look forward to is even of greater significance than college graduation.. nursing pinning. The nurse’s pin dates back to the early Maltese cross in which a pin was worn meaning a service of Christianity. The servants would care for others with communicable illnesses. Since then, the meaning of the pin has transformed throughout different cultures and programs. Florence Nightingale, the creator of the first structured program for nurses, eventually adopted the pin as a symbol of knowledge, servitude, and compassion for the vulnerable. Today, all nursing programs (and other non-nursing programs) culminate with the ceremony of pinning.

As a practicing RN, we receive different pins to put on our badge. These include acknowledgements such as various awards, employee of the month, degrees, and years of service, among others.

Earlier this month, I received my 5 years of service pin. It feels like I have been a nurse for so much longer, while also feeling like just yesterday I spoke at my own nursing pinning ceremony. In 5 years of graduating with my ASN, I completed a BSN, got trained in chemotherapy and Pediatrics, became certified in Medical-Surgical Nursing and ACLS, worked as a Charge Nurse on weekends and nights during the peak of the Covid-19 pandemic, and now have the greatest honor of teaching last semester nursing students at a community college.

While I receive my 5-year pin, I have the honor of providing the nursing pin to all of my students. And in reminiscence of my own pinning, I recite the nurse’s prayer:

Give us strength and wisdom when others need our touch

A soothing word to speak to us, our hearts yearn for so much

Give us joy and laughter to lift a weary soul

Pour in us compassion to make the broken whole

Give us gentle, healing hands for those placed in our care

A blessing to those who need us, this is our Nurse’s prayer

Until next shift,

Shania

https://pubmed.ncbi.nlm.nih.gov/2694101/#:~:text=The%20nursing%20pin%20is%20a,symbol%20of%20service%20to%20Christianity.

It’s okay to take up space

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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

Living as an Oxymoron

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Do you ever get a little bit tired of life? Like you’re not really happy, but you don’t wanna die?

“Having anxiety and depression is like feeling tired and scared at the same time. It’s the fear of failure, but no urge to be productive. It’s feeling everything at once, then feeling paralyzingly numb.”

As Em Beihold in her song “Numb Little Bug” and Rich Wilkerson Jr. brings to life, mental health matters. Did you know that female nurses are 70% more likely to die by suicide than female doctors, and nurses, in general, have higher rates of suicide than physicians and even the public (WebMD)?

We screen patients for suicidal and homicidal ideation on admission with questionnaires like the Columbia- Suicide Severity Rating Scale (C-SSRS).. “Do you ever fall asleep and hope to not wake up?”

“Have you ever had any thoughts of killing yourself?”

“Have you ever planned to end your life?”

Some patients laugh at these questions or make jokes about living with their spouse, however, more increasingly patients rate positive on these scales and require closer surveillance. The importance of checking in with our co workers also cannot go unnoticed. Working a stressful job on top of having anxiety, depression, or other mental health condition creates a difficult shift in itself. As patients are presenting with higher levels of aggression and/or are increasingly sicker, the job becomes more taxing. The struggle with mental health is that it is not often seen, unless carefully observed.

Taking time to fully listen to others, honestly answer “How are you?”, and having a healthy level of self-awareness is crucial to promote a healthy mindset.

Knowing that violence, depression, and anxiety are not “just part of the job,” allows solutions to be made. Speak up and speak out for yourself and others’ wellbeing. I am lucky to only have anxiety, rather than the anxiety-depression duo. Every day I take my pill and work on myself to create a life worth living.

If you ever need someone to talk to (even if we have never met), send me a message.

Until next shift,

Shania

Defensive Medicine: Protect Thyself

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The NIH defines defensive medicine as “departing from normal medicine practice as a safeguard from litigation.” In essence, it is over-prescribing to prevent from getting sued due to missing any clinical components. But this isn’t the type of defensive medicine I am referring to. The type of defensive medicine I am talking about involves appropriately and effectively documenting in order to cover your a**. We often use the improper term of CYA documentation.

“If it’s not charted, it wasn’t done.” This is a phrase I heard all of the time in nursing school. I understood this intellectually when it came to nursing skills, procedures, and medications, however, I didn’t realize that I would need to document a physician response, tagging and changing IV tubing, patient education, patient mobility, etc. Even the most mundane nursing activities must be documented.

In order to protect yourself from lawsuits or chart reviews, we have to chart everything that we do to our patient during our shift. It always made me laugh when I had to document inappropriate patient comments or physician responses that were either rude or incomplete. Documentation is what saves your butt. Even though it’s tedious, it is necessary.

Remember to CYA.

Until next shift, Shania

Communicating for Change

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“All communication must lead to change”- Aristotle

In acting, we learn that words are useless. Words only become effective once humans add purpose to them. The greatest actors understand the power of each word and use that power effectively to change the person they are speaking to. The change can be a perspective of a topic or a perspective about themself. We sometimes use the same words with different meanings or inflections to mean different things. This is the beauty of language and communication.

We conducted a communication survey within our facility to evaluate our current communication methods, strategies, and opportunities. A majority of the respondents voiced that they were “not confident” or “fairly confident” about our internal communication, communication with hostile patients/ family members, and communication to different departments.

With Covid, we realized that nurses are out of practice with communicating with visitors and the routine communication with interdisciplinary staff, most of which was eliminated during Covid.

There are two main types of communication that can be evaluated here: assertive communication and aggressive communication. Assertive communication is standing up for your beliefs, voicing your concerns, and not being afraid to communicate different viewpoints. Assertive communication is essential for leaders as it does not just go with the flow, but uses words effectively to evoke a positive change. Aggressive communication is not normally effective because it downplays other views, does not accept criticism, and has the “I am always right” mentality. Rather than offering suggestion like assertive communication, aggressive communication demands a certain way.

Communication is essential for a healthy work environment and relationship with coworkers. Ensuring that all voices are heard, points are spoken clearly, and evaluating different approaches are all ways to improve current communication modalities. If people have the sense that they have a say, their motivation for change can be greatly improved.

To Err is Human- A Case for Medical Errors

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“To Err is human; to forgive, divine”- Alexander Pope

In light of the recent criminalization of former Nurse Radonda Vaught, the topic of medical errors is quite relevant. According to the National Institute of Health, “Medical errors cost $20 billion per year and take the lives of 100,000 people every year.”

There are many different types of medical errors and reporting such errors helps to improve the process and prevent repeatable errors in the future.

Medicinal errors can include acts of omission (not giving a medication when it is ordered) or commission (giving the wrong medication). The main 5 rights of medication administration are taught in nursing school: right patient, right drug, right route, right dose, right time. We are taught to do no harm and every nurses’ fear is to kill somebody.

If a nurse tells you they they have never made a medication error before, they are likely lying. A lot of the time, the error causes no harm and goes basically unnoticed. The nurse will communicate the error to the appropriate people and it is evaluated and a new process may be created. That’s it. In the unfortunate cases where the patient is harmed or dies, that is when the stakes are higher. But, every single error made can possibly lead to death. Fortunately, most of the time the nurse can take a deep breath and carry on with the shift.

Medicinal errors can involve:

Giving the patient a medicine they are allergic to (most often this is caught with electronic systems and pharmacy checks, sometimes it is not flagged),

Giving a drug that the doctor ordered on the wrong patient (nurses can catch this if they understand what the medication does and the story of the patient)

Giving the correct drug but wrong patient label (same drug, same dose, wrong patient)

And so so many more scenarios.. some are very minor and are not noticed. Some are major and become national news. But ALL are human errors involving medicine.

What makes this case so scary for nurses is that reporting a medical error previously is already shameful no matter how small or big. And now that Vaught is now labeled a criminal, many more errors will now go unreported. In a time where we are facing an ever increasing nursing shortage, and now sending nurses to prison for a medical error, how is that going to affect the future nursing workforce?

The healthcare system is in need of some major changes. Where is the forgiveness that is indeed divine?

Until next shift,

Shania

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615-856-8181
shania@shanialynnvo.com