Shania Lynn
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patienttalk

Tips for new nurses

November 30, 2019 by NurseTwain

  1. Nurse the patient, not the computer. New nurses are very task-oriented and focused on completing what needs to be done for the day. It is so easy to focus solely on the screen and not even make eye contact with the human being in the room. It is important to listen to the patient and family, as well as to establish rapport. “If it is not documented, it wasn’t done.” Save documenting until everyone is properly cared for. Do not leave a patient unattended because documenting is behind.. you can always back-time.
  2. You do not work for the doctor, you work for the hospital. This was the most helpful advice my preceptor gave me during orientation. I would get so upset if a doctor yelled at me, but they have no right to do that. We are employed by the hospital, not the physician. Be respectful and follow their orders, but do not be afraid to question orders or ask for clarification, especially if you are concerned about the patient.. They see the patient for roughly 30 minutes, we see them for 12 hours.
  3. Smile. There are many difficulties and frustrations with nursing, but complaining does not solve anything. No one wants to be admitted into the hospital, just smile. It brightens the environment, is proven to make you in a better mood, and people are less likely to yell at you.
  4. Take every opportunity. Learning comes with experience, so take every chance and opportunity to grow. Nursing is a profession, and treat it like one. Be enthusiastic for what you have worked so hard for. Act like you are confident, even when you are not.
  5. Care for yourself. Do something every day that is for you. Whether that being reading, taking a bubble bath, making your favorite food, or watching your favorite show. Make sure you have a healthy you-time to destress from the previous shift. Exercise, eat right, and be kind to yourself.
  6. Set goals. Getting a certification, moving to a new specialty, earning a higher education. Have something to aspire.
  7. Remember you are one person.
  8. Invest in compression socks.

Until next shift,

Shania

Filed Under: Nursing tips Tagged With: learning, newnurses, nursing, patient, patienttalk, tips

Death: You cannot doubt God

November 30, 2019 by NurseTwain

“What matters is not the meaning of life in general, but rather the specific meaning of a person’s life at a given moment” – Man’s Search for Meaning by Viktor Frankl 

Working with many hospice families on the medical floor, there are so many stories that cannot be explained by science, alone. Each death is different, surprising, and often, beautiful. Supporting a grieving family as they wait and watch their loved one take their last breath brings me to the core of nursing care. No computer, no doctor, no book, and no prayer can comfort like the personal touch of the nurse.

I have seen oxygen saturations in the 70s jump to 100% as a family member walks in to say goodbye. I have seen patients who hang on until they find their last bit of closure whatever that may be before crossing over. I have seen obtunded patients open their eyes and use all of their remaining energy to say a few last words to their family members before closing their eyes for eternity. Death is and can be beautiful.

The first death I experienced was when I was still on orientation. It was a man who battled many years of cancer. He was literally skin on bones. His daughters and wife were at bedside, and it is the family that breaks your heart the most. They sat around his bed and talked about all of the memories that they shared together. They showed me a picture of him, a healthy 180lb man, now a 60lb man laying in the bed. Those are images you can’t forget.

Caring for Hospice patients and families is some of my favorite cases because of how real and genuine the emotions are. At the bedside, nothing else matters except the love and belonging the family has left.

Some families grieve with anger, some with prayer, some with thankfulness, and some with silence. Some patients wait for families to step out of the room before passing, some wait for a bath, some wait for a blessing, and some go suddenly.

It is crucial to maintain the compassion for each of these families. It is easy to appear too busy or even to become insensitive to these life events. The most important thing for palliative care and hospice is to simply be present. Sit down and listen to the family wishes and hopes. It is okay to cry with them, I often do. Cry, and then carry on. Focus on each patent encounter individually. One room at a time.

Death is a beautiful thing.

Until next shift,

Shania

Filed Under: patient stories Tagged With: death, god, hospice, nursing, palliative, patient, patienttalk

The patient with the black fingers

November 30, 2019 by NurseTwain

**Note: Any patient identification has been substituted to maintain confidentiality.

I had a patient last week who was found to have necrosis due to an extended infection. Her fingers were black and necrotic, however she still c/o severe pain in her hand. That morning, we had pleasant rapport and she was able to get up to the chair. Labs and VS remained stable until after lunch. Her BP started to drop with the systolic in the 70s and 80s and was resistant to fluid resuscitation. The pt was asymptomatic minus mild lethargy.

Family came to the room and quickly notified staff of a change in her condition. She was found to be slumped in the chair, however still response to commands. She was placed in the bed and MD notified.

By the end of the shift and transitioning to night shift, the pt skipped dinner and just wished to sleep in the bed. I went home.

The first thing I did when I logged in the next morning was to check on her BP overnight and review her progress. An alert came up stating that I was accessing a deceased patient. My BP immediately dropped.

The pt continued to get worse overnight and refused treatment. Her wish was to go home to Jesus and that is exactly what she did. Regardless of her wishes, I am still in shock of the events that took place that day and night.

It is so scary to realize how quickly a “stable” patient can decline. The previous morning she was up in her chair and talking to me as I am dressing her wounds. Today, she is sitting alongside Jesus’ throne.

Until next shift,

Shania

Filed Under: Uncategorized Tagged With: necrosis, nursing, patient, patienttalk

The patient that confirmed my specialty

November 30, 2019 by NurseTwain

**Note: All names have been changed to protect patient confidentiality. This post contains graphic content and portrays the events of the shift without disclosing any patient specifics.

I originally started on a medical-surgical floor to utilize and master all of the nursing skills that were practiced in the skills lab. The first year on my own, I had an oncology patient that decided my specialty.

Oncology has always fascinated me, both biologically and emotionally. Each cancer patient I cared for were always so humble and gracious to receive the care that was provided for them in the hospital. I had one family that I will never forget.

This family came in and out of the unit every few weeks to either receive chemotherapy or to receive treatment from the complications that the chemo had caused.

This day was the beginning of the end for the Smiths. Sean could not stay awake and was increasingly disoriented. He would have brief episodes of lucid behavior and his wife would cling to these moments with all of her hope. She had a faith that could move mountains. She believed in miracles and frequently voiced how God would turn this around. I would sit with her and pray for strength and healing regardless of the outcome.

Sean’s H/H continuously decreased. He was passing clots through his rectum. I have never seen anything like it before and still have yet to witness such a horrifying event. Bright red blood passed like a fountain through his rectum whenever he stood up. It covered the floor and looked like a bucket of red paint was knocked off of the table. Luckily, his wife was not there to witness this. We safely got the patient back to bed and bleached the floor. You could still smell the scent of the massive GI bleed that had just occurred.

He had a critical hemoglobin, hematocrit, and platelet level. The oncologist had ordered 2 units of platelets, 1 unit of plasma, and 2 units of PRBCs. I remained in this room until late that afternoon. Due to the massive influx of IV fluids, Sean went into fluid overload. He was prescribed lasix in an attempt to counteract the extra fluids, and then we waited to see what his labs looked like the next morning.

Long story short, He died that night. I remember that I cried the next time I came back to the hospital and heard this news. I knew deep down that this was probably for the best as he was suffering, but I could not help thinking about the beautiful conversations of hope and healing I had with this family… and all the prayers that were not answered as we had hoped.

I sent a condolence card to the funeral home, but did not attend the funeral. The city was over two hours from my house, and I decided not to go. Now, two years later, I wish that I had.

I got a recognition letter from my manager the day after this shift to recognize the hard work I had put in to keep this family comfortable. Oncology continues to be a specialty that I will pursue whenever an opportunity arises.

Until next shift,

Shania

Filed Under: Uncategorized Tagged With: medicalsurgical, newnurse, oncology, patient, patienttalk, specialty

Shania Lynn, RN, Voiceactor

November 29, 2019 by NurseTwain

The Cure for the Common Read

Hello! My name is Shania and I am a nurse at a rural hospital in Tennessee. I have been a medical-surgical nurse for 5 years and have learned and experienced many blessings and tragedies during my first two years at the bedside. Patient Talk is my public place to voice my emotions after a 12-hour shift with no sugar-coating (while being confidential, of course).

The name “Patient Talk” was created because it is importance to be patient with our patients, even on the hardest days. It is a reminder to be fully present with each patient. Electronic medical records consume most of our day and we quickly fall into the trap of nursing a machine, rather than the human being in the bed.

I will be discussing the patients that have warmed my heart, made me feel like I want to quit my job, and those that remind me of why I have chosen this profession.

I will relay tips to new nursing grads, along with tidbits of knowledge that I have learned during a previous shift.

I will also discuss any relevant topics in nursing, medicine, and healthcare in general as my brain wanders.

Once again, this blog is a safe place to refuel me for the next shift. It is a reminder to have “Patient Talk,” and to remember the reason behind being a nurse. Nursing is the hardest thing I have ever decided to pursue, but it is also the most rewarding decision I have decided to make with my life.

I hope all who read this can celebrate and relate with me in my victories, valleys, and challenges in the life of nursing.

Visit my website: https://shanialynnvo.com/

Until next shift,

Shania

Filed Under: Introduction Tagged With: medicine, nursing, patient, patienttalk, zerotohero

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