Prior to becoming a nurse, many individuals view the profession of nursing as an exciting and often alluring career. However, after years of practicing in nursing, the nurse often loses site of the true meaning of being a nurse.  With this loss, the everyday duties of passing medications, charting and procedures, in addition to the long hours become the primary focal point of “the job”. Yes, the profession of a nurse includes responsibilities such as bedpans and dressing changes, but there is so much more to this profession.

Being a nurse is one of the greatest privileges bestowed. A nurse is allowed into the lives and most inner thoughts and feelings of the patients, families and significant others they are entrusted to care for. Of course there will always be those days that are not so glamorous or attractive. But at the end of the day the nurse must ask themselves, what are the most important aspirations in life?

With this in mind, I am always brought back to the following poem:

Being A Nurse Means…..

You will never be bored.
You will always be frustrated.
You will be surrounded by challenge.
So much to do and so little time.
You will carry immense responsibilities
and very little authority.
You will step into people’s lives
and you will make a difference.
Some will bless you ~ Some will curse you.
You will see people at their worst
and at their best.
You will never cease to be amazed
at peoples capacity for
Love, Courage and Endurance.
You will see life end ~ and begin.
You will experience resounding triumphs
and some devastating failures.
You will cry a lot ~ you will laugh a lot.
You will know what it is to be human
and to be humane.

   ~ Melodie Chenevert

What a wonderful, rewarding and challenging profession!!! 

From co-Author:

Martha Hayton, MSN, ARNP-C, CWS
Director, Practical Nursing Program
Pasco County Campus

November 4 through 10 is Health Information and Technology (HI&T) Week

This annual event recognizes the work of health information management (HIM) professionals who maintain and protect the health information of consumers from coast to coast.

Every wonder where all of the thousands of medical records generate are stored? Hospitals and doctor’s offices as well as other treatment centers spend thousands of dollars each year to maintain the integrity and confidentiality of your medical history. You may be familiar or have heard the acronym HIPAA used when referring to the confidentiality of a health record. The Health Insurance Portability and Accountability Act (HIPAA) is a group of federal law originally designed to establish rights, protections, and other standards of care for working people with pre-existing medical conditions. This act along with others has helped to define the process by which health information is shared and stored. Health Information Technicians are individuals who ensure the accuracy, completeness, coding, security, storage and retrieval of health care-related data.

We are glad to celebrate this week in their honor!

Notice how HIPAA can be stretched to include the blogging world!

Tis the season for goblins and ghosts, I am moved to write about nurse’s experiences with spirits! So many nurses have had experiences that it does make you believe…….

There is a lot of literature regarding near death experiences and of spirits. I would like to share stories I have heard over the years and of course some of my own.

My first experience with a spirit was when I worked nights in a Long Term Care unit. I was an LPN at the time and worked closely with the assistant. We both loved horror movies and enjoyed discussing our favorite scenes. As we were doing rounds, we noticed that the wet linen dangling over the cart side began to sway back and forth. At one point it stopped, then started on its own again! Later that morning a resident died. Was someone waiting and in the mean time having a little fun?

Another situation that I experienced was while working with a client in ICU. He was quite sick and very weak. All of a sudden he sat up and began talking to the end of his bed. I asked the client who he was talking too and he replied, “My Mom, Dad, and Brother Bruce, can’t you see them waiting for me?” One hour later the client coded and died.

As a float nurse, I worked on a very busy night on a surgical floor. The client I was caring for was very ill. He had 5 solutions running in and needed 2 IV pumps with standards. The alarms of one of the pumps kept sounding. After trouble shooting the pump without success, I went to exchange the pump. I programmed the new pump and after hitting start, it did not take long for the alarm to sound again! At this point my patience was running out so I said out loud “I really don’t have time for this.” The pump alarm sounded no more!

I would like to share one more of the many stories I have heard over the years. While working in the ER one quiet night, the staff were all sharing ghostly experiences. One of my favorite nurses shared that after an unsuccessful code she had a very ghostly experience. As she cleaned and prepared the body for family viewing, she saw a white, faint, glow rise from the body then dissipated.

Do spirits come to greet their loved ones? I love the thought!

So on a fall cool evening, during a full moon, have a get together and discuss your ghost stories!

From Co-Author:

Pam Stellmach
St. Cloud Campus

Nursing is such an interesting profession.  Sometimes it is filled with the tragedy and frailty of human life.  It can be so sad when a loved one dies, or a young person is permanently injured or scarred for life from medical treatments. 

I began my nursing career working in oncology.  My family didn’t understand why I would choose such a depressing place.  I never did find it depressing.  I found it to be full of caring people and funny people too.

I think it always helps to recognize that humans are funny and the medical profession provides great opportunities for humor.  I mean really, where else but hospitals would you share a room with a complete strange, wear a backless gowns and discuss bodily functions over lunch?

Some of my fondest memories in my career happen to also be the funniest.  Perhaps the one that can make me smile or chuckle on a really gray dismal day is how we coped with a really serious situation.  We had a young patient who had a rare type of cancer and it spread to the pericardium.  He was about to undergo placing a catheter into his pericardium in order to receive experimental chemotherapy.  He went off to surgery and we nurses prepared the room for his return; had an open surgical bed, oxygen, heart monitors and IVs at the ready. 

We got the phone call from surgery saying the “Heart’ was on its way up to us.  Everyone scurried to be ready to transfer the patient back to the bed.  Nurse’s were standing by the doorways and had the halls cleared because the “Heart was coming.”  You can almost hear the marching of the nurse’s feet as they pushed the gurney on to the unit: bappity, bap, bap, bappity bap bap. And there was my friend.  In preparation for the “Heart”, she had taken two oxygen masks, tied them together and draped them over her ears; she donned her shades, and grabbed two flashlights.  With her skillful direction as an aircraft landing technician, she waved the gurney onto the unit and into the room across from the desk.  Any airplane could have landed safely under her care.  The nurses and the surgeon could hardly contain themselves to get the chuckling patient into bed. 

I am sure other nurses can tell the tales of what they find to be funny.  That humor has a great way of reducing the stress during what can be a tense time.  Humor is sometimes a difficult medium to use when in stress because one has to be careful not to offend others or make them the butt of jokes.  Here is another example of how a stressful situation became less stressful.

I cared for a lady who had a colostomy as a result of cancer.  She was having problems getting her appliance to stick and her skin was an excoriated mess of raw red painful tissue.  To make matters worse, she had diarrhea and we while we worked on maintaining her fluids and electrolytes, she continued to have problems.  She put her call light on when the bag exploded in a mess.  I sighed and went to help her get cleaned up.  I worked hard and had her all neat and clean, fluffed and puffed when it happened. 

She exploded again.  She wanted to cry.  We started over yet again. 

Finally, I was preparing to leave the room with my armful of soiled linen, and you guessed it.  Explosion!  Massive amounts of brown goop everywhere!  She uttered a four letter word that begins with S.  I could only reply back, “Yep.  That’s what it is.”  The patient looked startled when I agreed with her assessment.  Pretty soon she was laughing out loud at how ridiculous it had become.  Soon she had the appliance on and I was through changing linen.  Fortunately for the both of us, it was the final linen change of the evening.

Nurses have to be able to remain calm in emergencies and able to be compassionate when the time is right.  Most importantly, they need to have a sense of humor in order to provide care across the continuum of human emotions. 

Laughter can reduce stress and lighten workloads.  It also provides a great way to make nursing a fun career.

From Co-Author:

Cheryl Pratt, RN, MA, CNAA
Practical Nursing Director
Mankato Campus

As nurses and nursing students, we take pride in being part of a helping profession.  As a former critical care nurse, I enjoyed the “adrenalin rush” of knowing that I had helped save a patient’s life.  The joy in nursing is realizing you have made a difference in someone’s life or the life of their loved one.

But what are professional boundaries, and how do we know if we have crossed them?

On Thanksgiving Day several years ago, I was working a very hectic day shift in the ICU.   Throughout the day, I was thinking about getting home to my family and enjoying turkey dinner with them.  As I spoke about this to another nurse during my break time, she told me that she was planning on staying late and eating dinner with a patient, instead of going home to her family.  When I asked why, she said that the patient’s family had asked her to join them, and she didn’t know how to say no. At the time I thought, “How could I be so selfish in wanting to spend time with my family instead of with a patient?”  It wasn’t until years later that I realized that my thoughts were actually “healthy”. 

Many times in nursing, we want to be the savior, and we want everyone to think we are kind and giving all of the time. But we need to realize, we are human, and we have our own needs.  It IS important to be professional, compassionate, dutiful, and competent at work, but it is okay to set limits. By denying our own needs, we can become resentful, “burned out”, and fall into the bottomless pit of feeling like we are in a thankless job.  A few years later, I learned that this nurse had left nursing all together.  I was not surprised.  She had a pattern of using patients to meet her own needs for approval and acceptance and felt that if she said “no”, patients wouldn’t like her.

Maintaining professional boundaries means practicing nursing in accordance with the Nurse Practice Act.  It has occurred to me many times throughout my career, that nurses may not even be familiar with the document that guides their profession.  As student nurses, you will need to follow the guidelines set forth in the Nurse Practice Act.  It will help you to understand your professional role as a nurse and how your behavior affects the vulnerable role of the patient.

But how do you know if you have crossed professional boundaries with a patient? 

As a student nurse, here are some questions to ask yourself: 

Do you give your home phone number or cell phone number to patients or families?

Do you tell patients or families details about your private life such as the state of your marriage or your “difficult” nursing instructor?

Do you ask your patient personal questions that having nothing to do with the medical care or condition you are treating?

Do you go above and beyond for a patient in hopes that they will tell you that “you are the best student nurse they ever had” or to put it another way, do you seek approval from your patients?

Do you think about a patient constantly when you are not at your clinicals?  Do you wonder if any other student nurse can give your patient the excellent care that only you can provide?

Do your actions do more to meet your own needs instead of the patient’s?

If you answered yes to any of these questions, I would suggest that you review the Nurse Practice Act as well as talk to a trusted instructor or nurse mentor.  You will want to avoid the pitfalls of going “above and beyond the call of duty”.  Without the “emotional baggage” of crossing professional boundaries, you can then become the competent, empathic, and most of all, professional, nurse that you wish to become!

From Co-Author:

Kathleen Wedin, RN, BSN 
Associate Director of Nursing 
Brooklyn Park Campus

With healthy adults, a systematic review showed a significant decrease in days of work missed.

More importantly in the elderly, the vaccine decreased mortality, as well as hospital and outpatient visits for pneumonia and influenza. It also decreased death and hospitalization for influenza and pneumonia in those with chronic disease (i.e. stroke, rheumatologic disease, diabetes, heart, lung, kidney disease). Here is an interesting study published on Pubmed.org:

"BACKGROUND: Three different types of influenza vaccines are currently produced world wide. None is traditionally targeted to healthy adults. Despite the publication of a large number of clinical trials, there is still substantial uncertainty about the clinical effectiveness of influenza vaccines and this has negative impact on the vaccines acceptance and uptake.

SELECTION CRITERIA: Any randomized or quasi-randomized studies comparing influenza vaccines in humans with placebo, control vaccines or no intervention, or comparing types, doses or schedules of influenza vaccine. Live, attenuated or killed vaccines or fractions thereof administered by any route, irrespective of antigenic configuration were considered. Only studies assessing protection from exposure to naturally occurring influenza in healthy individuals aged 14 to 60 (irrespective of influenza immune status) were considered.

DATA COLLECTION AND ANALYSIS: Both clinically defined cases and serologically confirmed cases of influenza were considered as outcomes according to the authors' definitions. Time off work, complication, and hospitalization rates were considered, together with adverse effects. Vaccine schedules were analyzed including one component matching the recommended vaccine (WHO or government recommendations) for the year of the study, and whether they matched the circulating viral subtypes.

MAIN RESULTS: The recommended live aerosol vaccines reduced the number of cases of serologically confirmed influenza A by 48% (95% confidence interval 24% to 64%), whilst recommended inactivated parenteral vaccines had a vaccine efficacy of 68% (95% confidence interval 49% to 79%). The vaccines were less effective in reducing clinical influenza cases, with efficacies of 13% and 24% respectively. Use of the vaccine significantly reduced time off work, but only by 0.4 days for each influenza episode (95% confidence interval 0.1 to 0.8 days). Analysis of vaccines matching the circulating strain gave higher estimates of efficacy, whilst inclusion of all other vaccines reduced the efficacy.

REVIEWER"S CONCLUSIONS: Influenza vaccines are effective in reducing serologically confirmed cases of influenza A. However, they are not as effective in reducing cases of clinical influenza. The use of WHO recommended vaccines appears to enhance their effectiveness in practice."

In my position I often perform several interviews per week. I have been told that my interviewing techniques are often a bit unorthodox. I guess this is true since I tend not to ask typical interview questions found in “How to Interview” texts. My goal in any interview or dialog with a perfect stranger is to determine if my conversation buddy is passionate about life. Do they show enthusiasm about any particular subject?  Do they cry when they see the ocean and feel the sand? Do they scream when their team makes a touch down and spill their beer on the person sitting next to them? Do they wax the paint off the ‘55 Chevy?

It is amazing to me that a person can advance through life and never really develop a love or passion for any one given event or thing. I often hear the response that my kids are my passion or that I work so much that I suppose work is my passion. While both of these are deemed acceptable responses I like to dig bit deeper to see what really makes a person tick!

Take a moment to reflect. What is the one thing that you enjoy doing? What would you consider your one passion? What gives you great joy?

My father loves to restore furniture. He is extremely slow and will work on one piece for months or years because the item must be restored to perfection. He will spend hours carving out of wood a missing piece on an old chair until it perfectly matches the original. Nothing delights him more than to gaze at a completed restoration and to hear the compliments from those that viewed the original broken and ugly, old discarded relic as a piece of junk. They will often pay a great deal of money for the restored and now cherished antique.

My mother loves to paint. She is extremely talented with both oils and watercolors. She spends hours at a time sitting or standing in front of an easel creating a work of art. In the beginning, it is simply canvas and paint. In the end, it is a painting deemed a work of art.

Not long ago I was performing a couple of interviews and had a new manager observing the process. The first candidate was so boring she nearly put herself to sleep. No matter how determined I was, I simply could not discover her passion. I knew after a few moments of conversation that our customers would not appreciate us choosing her to help develop their future careers. The second candidate entered the room with a bounce in her step and a smile that was contagious. We were immediately drawn into a conversation about baking pastries and owning a restaurant. What a delight she was! The observing manager remarked that she realized after meeting the second candidate what was missing with the first. The first candidate has not discovered her passion.

It is extremely important to exhibit your collection of skills as well as your accomplishments in education. But even more importantly, you must expound on your passions. Show the person performing the interview that you are human. You laugh, cry, work hard and you are passionate about life. In a world were competition is high for the perfect job, one must exude determination and a passion for being the best. I often ask the question, “is it important to you to be the best or the best that you can be?’ 90% of the candidates will respond that it is important to be “the best that you can be.” How does a company determine “the best that they can be?” That is a copout! No one can measure “the best that you can be.” However you quickly know who the best is. They win medals in the Olympics and trophies at the races and promotions in the workplace and people by their furniture and paintings.

People are watching you.

What's your passion? Let it show!!