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patienttalk

The rise of Delta: not the airlines.

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Due to a high number of unvaccinated individuals and anti maskers, hospitals are now hit with a second covid-19 surge. I, as well as many other nurses, have experienced the nightmares of covid returning as beds are full, patients are sick, and staffing is strained.

The Delta variant is now the major strain in the US. It is about 2x more contagious and transmissible than the original covid-19, meaning that one infected person can infect upwards to 5 other people. Those who are unvaccinated including children are most at risk for infection and hospitalization.

Loss of taste and smell are less common with this variant and typical signs are symptoms resemble that of the flu including headache, sore throat, runny nose, and congestion.

Even with the variant, vaccination prevents 88% of people from having symptoms and 96% of people from ending up in the hospital.

Take home points:

Get vaccinated!

Wear a mask in public places.

Prevent the spread and help the strain on the hospital system.

Until next shift,

Shania

Time, Talent, Treasure

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From a young age, I always valued the concepts of time, talent, and treasure. These three qualities make or break a person’s life and I evaluated them within my own life in order to be successful and to be in a continuous state of growth.

  1. Time is such a valuable resource in the sense that you cannot get it back; it only keeps moving forward. Where you invest your time determines your future. I stated before in previous posts that my biggest fear is wasting my time on things that are unnecessary. Therefore, I make an effort to use my time for productive things, whether that is learning, growing my business, calling my grandmother, going to the gym, cooking a meal, or even watching a show I enjoy.. anything in moderation. I often make a to do list for every day and this helps me stay productive and make sure that I am making the most out of the time I have during the day. Atul Gawande wrote a great book on this topic, The Checklist Manifesto. I highly recommend!
  2. Talent. Talent is tricky because this is where your life purpose or passions come in. It is amazing to me how many people just settle because they don’t want to go out of their comfort zones, experience new things, and find why they are actually here on Earth. A talent isn’t just some child prodigy who wins America’s Got Talent. Talents are the unique qualities and interests that each person has. I enjoy people and helping people live healthier lives, therefore, I became a nurse. The stress and anxiety that comes with working in the hospital allows me to realize that I am not meant to stay in the hospital forever, at least not as my sole income. I also know that I have always loved acting and I am at a point in my life where I can actually pursue it professionally, alongside my nursing job. Talent is what keeps me motivated and reaching for me. As Ronnie Doss says, the comfort zone is the danger zone. It is dangerous to remain stagnant in life and never reaching for more.
  3. Treasure. Where your treasure is, there your heart will be. Look at your bank statements. Other than bills and living expenses, where do you spend the majority of your money? This reveals what your priorities are. Many times this money goes to food, alcohol, coffee, or toys. What about if much of it was invested, donated, given to others? It is important to be conscious where the excess is going and to monitor the outflow. Money is not inherently bad. So many great things can be done with proper funding. It is how money is used that can lead to trouble.

Where are you investing your time, talent, and treasure?

Until next shift,

Shania

RN Residency

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What did nursing school actually teach you? Are you ready to start caring for patients right out of school? Did the NCLEX really prepare you to be a bedside nurse? Probably not. Most nurses right out of school feel like they did not learn anything and have no idea what true nursing actually is. It is always so surprising that such a rigorous 2-4 year nursing program is so textbook-focused with such a small percentage of time actually at the bedside. Other careers actually prepare students to begin working right out of school- Doctors have a residency and fellowship for years, physical therapists have months of clinical experience before graduation, etc. Many nursing programs only have one clinical per week with the rest in nursing labs or lectures in the classroom. I definitely did not feel prepared after graduation to actually be a nurse. I had such a great knowledge base, but struggled to put all that knowledge into practice at the bedside.

One of the most important factors into considering what to look for in a first job is a residency program. Residency programs involve all of the new graduate nurses and equip those nurses to be confident and competent at the bedside. The program I completed 4 years ago was recently re-accredited by the ANA and I was so thankful for it. I will detail the aspects that was presented within my residency program:

  • one year in total; 1 session/month
  • Skills day- the first session was all about learning and relearning the specific nursing skills required for the job in your unit utilizing the specific hospital’s policy and supplies
  • Disease processes- relearning the different core measures and refreshing on different patient diagnosis
  • Mentorships- Experienced nurses have the opportunity to mentor the new grads
  • Evidence based practice- complete an EBP project on a topic of our choosing and present it at a hospital-wide EBP fair

These are just the highlights of my residency program, but it is so worth the extra time and effort to know how to be a great nurse.

Until next shift,

Shania

(W)holistic Care: One day at a time.

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When patients arrive to the ER, they present with a “chief complaint”, or the reason that they came to the hospital. We, of course, identify the problem and treat the diagnosis based on evidence based practice. But, we don’t just stop at the diagnosis, nurses identify other needs and even warning signs. We ask about a safe home environment, access to medications, assess health literacy, and even screen for suicidal ideation. This is called holistic care, or treating the whole person rather than just their chief complaint.

Holistic care involves ensuring each patient has the capability to understand their medical history and have access to the resources they need to stay healthy. It is easy to document that the patient refused or is noncompliant, but often their reasoning is quite innocent. Asking questions, and more importantly listening to our patients provides so much more useful information that helps to tie up their story. Doctors are often in and out of a patient room within 15 minutes (if that). I have seen doctors simply ask the nurse how the patient is doing without even laying eyes on them theirselves. Nurses have the opportunity to thoroughly identify each patient need and educational level.

Holistic care can be overwhelming if the patient requires many resources or additional time for teaching. I often remind my patients to take it one step and one day at a time. It is too much to think about everything that needs to be fixed or mended. Start with day one and one change then gradually add in additional disciplines. It all starts somewhere.

Until next shift,

Shania

Patient Talk

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“It’s easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience.”- Julius Caesar

Recently, I have found myself becoming slow to anger and quick to speak. I have to consciously think about taking a deep breath or even doing yoga to help calm myself down. This lack of patience, I’ve realized, seems to be from a lack of direction. The past few months, I have spent many hours in constant study and dedication to build up my voice acting business. I have spent much less time just being still. It is in the stillness that answers can be found and peace fills the soul. My mind is in constant flight mode as I attempt to audition for any job possible, reach out to as many people as time allows, while also tending to the home and spending time with my husband. I have neglected time for myself to simply sit and reflect on the achievements I have made in these past few months.

I have goals set each day to achieve, but have re-added items such as sit on the porch and read, drink a cup of coffee and watch a favorite show, just sit and be still. Calming my mind and stilling my body are the most challenging things for me to do as I always love to be in constant motion. However, in the loud world we live in, I realize that the peace that is now missing from my life may only return if I allow my body some rest.

Patience is not always easy to give others, yet alone ourselves. We must listen to our bodies and give them what they are craving. I am not normally an annoyed person, but I have definitely been short in times I do not mean to be recently. It’s the Patient Talk with ourselves that can help refuel the soul. I choose to check that off my list today and every day for the week ahead.

Until next shift,

Shania

Palliative Care: A Day in the Life

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“Life is pleasant; Death is peaceful. It’s the transition that is troublesome”- Isaac Asimov

Palliative care is a field of medicine that focuses on an individual’s and family’s quality of life as they suffer from a chronic illness. It involves ensuring the individual is knowledgeable about their disease process, has all of the resources they need to succeed, and can ultimately end with Hospice care.

Palliative care candidates are those who suffer from chronic illness such as heart failure, COPD, multiple sclerosis, cancer, etc. Hospice is a subset of the umbrella of palliative care, but not all palliative services involve hospice.

Palliative care enables individuals to have the best quality of life for their illness. With the knowledge they need to succeed, individuals with palliative care often live longer, go to the hospital less, and have a higher life satisfaction.

The team involves MDs, RNs, social workers, case managers, and more. They all work together to provide an extra layer of support and listening ears. The team may assist with arranging resources, pain control relating to the illness, advanced care planning, end of life wishes, among many others things.

Today, I got the opportunity to witness a beautiful conversation between a palliative care nurse and a wife of her very ill husband at the bedside in the ICU. The RN opened the conversation to the wife and the wife had unrealistic beliefs regarding her husband’s medical condition. The RN was able to answer questions regarding his diagnosis/prognosis, provide options, pray, and truly listen to the wife’s concerns. Here are a few questions/concerns the wife had that were answered:

  • What will happen if we turn off the machines?
  • Will the doctor say, ‘I told you so’?
  • Will he gasp for air?
  • How will I live without him?
  • I never lost hope in God. This just isn’t in his plan and that is so hard.
  • How do I tell my 3.5 year old granddaughter that papa is not coming home?
  • How do I call and start this conversation with my family?
  • He isn’t getting any better, but my heart hurts so much.
  • I know he wouldn’t want to be on life support, but how do I know when to stop it?

The Palliative Care team gives families and individuals the opportunity to discuss their concerns in a safe environment and the support when they may not even realize they need it. It is a heartbreaking field to be in, but it is truly a calling and the opportunity to witness this interaction was such a blessing.

Do you have any patients or family members that may benefit from palliative care?

Until next shift,

Shania

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615-856-8181
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