615-856-8181
shania@shanialynnvo.com

nursetwain

Defensive Medicine: Protect Thyself

by

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

It’s Just a Bad Shift: The Importance of Mindset

by

In the past several weeks, I have transitioned into a new job, got scammed out of $1000, lost and found my “sold” wedding dress, messed up my personal website, and our house closing has gotten delayed. Reflecting on these many frustrations, I remind myself that these are so little mishaps in the grand scheme of things.

I remind myself that I am so thankful that my family is healthy, my country is not under war, Covid numbers are decreasing, I have a successful side job that I love, we are building our first new home, among so many other amazing events that life brings.

There are bad days at the hospital, but there are also bad days at home. It is normal for humans to doubt their abilities and question our life paths. It is so easy to live in life’s frustrations, rather than choosing to embrace the oxygen that we breathe at every moment.

It’s our attitudes and perspectives that determine our outlook on each situation. It is so important to magnify the good and simply experience the bad. Experiencing every emotion- the good, bad, and ugly, is part of a healthy life. The problem lies in adopting a negative viewpoint that determines all future reactions and paths for greater things.

Inpatient nursing is already a high stress environment, so why bring such negative emotions and perspectives to the work? A negative aura is felt by others around you. It truly is amazing how just thinking negative thoughts can affect an outward appearance.

We need to choose to accept healthier perspectives and view all sides of a situation. A bright person is just as recognizable as a negative Nancy.

Until next shift,

Shania

What do you want to be when you grow up?

by

Growing up and even now, many ask themselves this question, “What do I want to be when I grow up?”

After witnessing mental illness in my family and then struggling with my own eating disorder, my answer became “a nurse.” I chose to be a nurse because I wanted to influence others and educate others into creating a healthy lifestyle.

But just the answer of being a “nurse”, only goes so far. I then decide whether I prefer inpatient or outpatient, which unit, which patient population, short term goals, long term goals, etc.

I, ultimately, settled into an adult medical-surgical floor that also served pediatrics and Oncology. I began nursing school wanting to do pediatrics, then ER, then inpatient oncology. There was rarely a job available at the infusion clinic, so I remained on med-surg for 5 years and I enjoyed it.

I started as a student nurse tech, then a nurse extern, then a new grad nurse, then staff nurse, then charge nurse, and now a nurse Retentionist! My medical unit offered classes on chemotherapy administration and pediatric care at no cost to me. I was able to get a wide variety of training and experiences by remaining on the medical floor for as long as I did. I also had the opportunity to switch shifts and worked days, nights, and weekend nights.

Each different experience I had and extra step I took for myself, allowed me to be open for leadership opportunities. My transition into a charge nurse was not as difficult as I thought. And the creation of my new position as a Nurse Retentionist, allowed me to step fully into the role as a nurses’ advocate and leader.

Though the actual transition away from the bedside and into a 8-4:30 job was difficult mentally, the actual work came natural. I was able to utilize my strengths of communication, boldness, and listening to incorporate challenges at the bedside into solutions to present to nursing leadership.

I never went into nursing school thinking I wanted to go into leadership, but it was something that found me and I love it. Though I am not a typical bedside nurse, I am still a nurse. Instead of caring for patients, I advocate for the nurses that continue to care for them.

What do you want to be when you grow up?

Until next time,

Shania

Funny Tidbits of Nursing Knowledge/ Nursing Advice

by

  • Be careful not to nurse the computer
  • Not everyone showers regularly
  • Everyone’s anatomy is different
  • It is not exactly like the case studies
  • I have never inspected so many butts
  • No, you cannot bring your monkeys to the hospital
  • If you smell smoke, one of your patients is probably smoking in their room
  • If you are a patient and walk across the street to taco bell, you will be forced to leave AMA
  • Allowing a patient to leave AMA will probably make your shift so much better- don’t take it personally!
  • It is a good morning when you only have one fingerstick.
  • Ensure quality > quantity
  • Sometimes the best position to place a foley is side-lying or doggy style
  • Just because a patient is in the hospital, does not mean that they can treat you like trash
  • You do not work for the doctors, you work for the hospital.- Stick up for yourself!
  • Family members are often worse than the patients, however if you listen, they can turn out to provide valuable information
  • Stay humble!- You will not know everything and there is always a resource to learn more
  • Be involved within your unit- building personal relationships with coworkers will make going into work so much better
  • The best nurses are those that start from the ground-up- Remember to appreciate and help EVS, NTs, etc.
  • Offer things the patients are allowed, rather than focusing on things they cannot have or cannot do

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

by

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

Addiction: A Disease Mentality

by

“History of IV drug use, positive for heroin and meth. HIV and Hep C positive. Constantly requests pain medication.”

What are your immediate thoughts when getting information like this in report? Most likely, it’s thoughts of judgement, disregard, lack of care and trust for the patient. Although these are valid thoughts, what about taking a step back and thinking about the reasons behind their IV drug use. What happened in their life that needs to be numbed by such harsh drugs?

Addiction is defined by the American Society of Addiction Medicine as ” a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction, use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.”

Everyone wants to be happy; no one chooses to do things because they know it will make them unhappy. Often times, the perfect combination of an addictive gene plus a poor life circumstance and environment leads someone to choose a substance as a coping mechanism. Society encourages people with a bad day to “go have a drink” after a rough day. So many scenarios can become the ultimate formula that leads someone to a substance and the individual then is a slippery slope into a life of addiction.

Do they choose the drug to feel good? They keep searching for that next high, but develop an increasing tolerance so they need more and more until an accidental overdose. Do they choose the drug to numb a hurt? It’s easier to drink a beer “socially” than it is to do yoga, meditate, go on a walk. It’s justifiable and becomes rationalized.

Some realize the problem, others do not admit that they have a problem. Those that want to change, now must detox safely in a facility. What started as a way to cope from a tragic event led to a life of pain and hurt from a drug that only fuels the fire.

A majority of addictions are not illegal, but trigger the same brain chemistry. Think about your own addictions and how hard it may be to break those and then compare it to a pill or form of liquid death that it’s sole purpose is to disrupt a certain brain-body signal. Addictions to sugar, caffeine, nicotine, technology…

Until next shift,

Shania

©2025 Shania Lynn Dubbert // Voice Over Site by Voice Actor Websites
Website Hosting provided by UpperLevel Hosting

615-856-8181
shania@shanialynnvo.com