Archive for April, 2007

Published by Sean on 19 Apr 2007

Charlie’s Leg and a Nursing Rant

I am tired tonight. I’m switching from days to nights by staying up all night, and my body is NOT happy about it. Normally it’s not a big deal, but three days ago I was asking my body to switch from nights to days. Seriously, how cruel is it to give me a schedule that involves working night shifts for two weeks, then two day shifts, and then back to nights for two weeks. Yes, I shall be dead before I’m forty!

Charlie had his splint off today. I dropped him off at the vet early in the morning and took off to run errands while the vet took an x-ray and examined his leg. When I picked Charlie up, he had a cone on his head and he looked miserable! The leg is just fine; however, he would not stop licking his foot/leg. So, until he stops, he will have to wear the cone (all that licking could cause an infection). He spent the afternoon under the coffee table looking completely unimpressed with the entire day.

The poor guy is having trouble walking. You can tell by looking at the leg that it is much weaker than his healthy leg. Weeks of not using the muscles of caused them to become imperfect. On top of that, he seems confused by the lack of splint–he had become so used to it! Four weeks is a lot of time in the life of a fifteen-week-old puppy. So, he needs to strengthen his leg and learn to use it again. I wonder if there’s a doggy physiotherapist around here.

I enjoyed the day off with a vehicle (Richard got a ride to work so I could use the van to take Charlie to the vet). I bought a couple books at Chapters, sipped tea at Starbucks, bought Richard some pants, and wondered around the mall. I forgot how much better it is to have a vehicle of my own. I was reminded of the freedom a vehicle allowed, and it pleasantly intoxicated me! I may just decided to buy that new Honda Civic after all.

Patience! That’s what I need! I need to pay off a couple debts, then try to get approved for a mortgage…and when that fails, I can get my fancy new Honda Civic.

Work is driving me to the point of insanity. There are just too many patients and too little time. I am so disheartened by all the “solutions” that are being introduced in order to help speed up admissions to the hospital, and thereby reduce ER wait times.

For the record, I am absolutely tired of the news reporting that the long waits are due to a massive bed shortage. To whomever is listening THE REPORTS OF THERE BEING A BED SHORTAGE ARE FOR THE MOST PART A MYTH!!!!! That felt good…

The news keeps stating over and over again that there is a critical bed shortage and that we need to hurry up and build new hospitals, and add on to current ones in order to ease the crunch. The news reports that because of this shortage of beds, patients in the ER have to wait thirteen hours or so to be admitted.

The problem with that is that there are dozens of beds in my hospital that lay empty at every moment of the day. On my unit there are usually four and sometimes eight beds that lay empty all the time. So, why aren’t patients being admitted to these empty beds? BECAUSE THERE ARE NO NURSES TO TAKE CARE OF THEM.

Sorry for the capitals, but seriously, why does this fact seem to escape the media, the health region, and the Government? Why do all of these institutions insist that building more beds will solve the problem? They are building a big hospital down south, but if there’s not enough nurses to run the hospitals we have, then who will run the new hospital?

So, the “solutions” to the ER wait times? They have implemented what they call “Triggers.” For example, if someone has been in the ER for four hours (the four hour limit being the trigger), they will be sent to a unit whether there’s a bed available or not. If someone has been in the post anesthetic recovery room for a certain amount of time, they will be sent to a unit whether there’s room or not.

They expect us to admit these patients post-op and from the ER and care for them in the hallways. This is about as unsafe as it gets! Not only does it overwhelm the nursing staff (I didn’t think we could be more overwhelmed…I guess this will prove me wrong), but putting patients in hallways means that we don’t have emergency equipment available at the bedside.

What we need is MORE NURSES. We need to find innovative ways to attract AND KEEP nurses to the city. This could include great signing bonuses, competitive wages (not to nurses in other provinces, but to other, similarly educated people in this city), excellent benefits (seriously, shouldn’t nurses have good health benefits?), and more than anything…a positive work environment.

What we don’t need (which we are experiencing) is difficulty getting a pay increase that even comes close to matching cost of living increase. The government wants to give us a couple percent raise over the next few years. They are also attempting to roll back many of our benefits. Is this really a time to take a step backward?!?!?!?!

This in a city, where on a full time nursing wage, you can’t even get approved for a mortgage for a 500 square condo. If you doubled a nurse’s wage, he/she would be able to just barely get approved for that bachelor suite (assuming they don’t own a car or have an ounce of debt). On a nurse’s wage, even renting a one bedroom apartment can potentially take up half of your paycheck.

Ok, I’m going to stop there. Rant over. I could type for hours about this issue, but I need to stop somewhere.

Published by Sean on 06 Apr 2007

Late Night Finds on Youtube

I loved this video! He was inspired to create it after seeing that he passed his RN exam. It represents the same feelings of transformation that I am experiencing.

ARG!!! This sounds incredibly interesting! I wish it was the entire show, rather than just a short intro.

This guy made me giggle! I love the all white scrubs, complete with white cowboy shirt. I have never thought to taste my patient’s poo for blood…interesting. And, the scene of him chasing the patient down the hall…I’ve been there…I’m sure we all have.

Published by Sean on 05 Apr 2007

Odds and Ends at 3:00am

First of all, thank you everyone for your kind messages following my last post declaring that I passed my exam and am now a Registered Nurse (god, just writing that made me swoon with joy). I need to correct myself by stating that I am not a registered nurse quite yet. Let me explain…

I wrote my exam February 7th, 2007. I received my results and I passed, but that does not automatically make me a registered nurse. I do indeed need to actually register with the College and Association of Registered Nurses of Alberta. So, I am still a Grad Nurse in the meantime.

The process to register will probably take awhile. I will be sending them my registration form tomorrow; however, they cannot register me until they receive my transcripts from the University showing that they have granted my degree. Even though I finished my course work in December, the University will not grant my degree until June 14th. So, I probably won’t receive my license until July. Did that make any sense?

The odd thing is that when I receive my license, it is valid retro to February 7th when I wrote my exam. So, Today on April 5th, 2007 I am not a Registered Nurse. However, when I receive my license in July, I will be able to say I was a Registered Nurse on April 5th, 2007. CRAZY!

They definitely need to find an easier way to do this….

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I’m not sure how the continued competencies work elsewhere, but here in Alberta they have a system in which we tell them what we want to learn and how we plan to learn it, then we need to provide evidence that we followed through.

However, you cannot just choose random things to learn. Instead, you have to study CARNA’s list of what they call “indicators,” or competencies that they expect Registered Nurses to have. They expect you to choose 1-3 of these indicators to work on. I chose the following:

1.) “I follow current legislation, standards and policies relevant to my profession and my practice setting.”

I chose this indicator because I feel I rely too much on other nurses when I need to learn a skill. What I mean is, if I don’t know how to do a task, I will just pull aside another nurse and beg for help. I would instead like to focus more on learning from our policies that are set out for us. This way I will learn to do things properly and without bad habits. Furthermore, these policies are in place because they are based on evidence, and even better, they are SAFE!

2.) “I question policies and procedures inconsistent with therapeutic patient/client outcomes, best practices and safety standards”

I am a new nurse and occasionally naive. Far too often I perform orders from doctors without second thought because I trust that they are practicing safely. As we all know, that is not a safe way for ME to practice. An example would be questioning why the doctor has unexpectedly ordered a large bolus of fluid with no real apparent reasons. I would like to work on becoming more comfortable questioning doctor’s orders (and of course the practice of other health care workers).

3.) “I support decisions with evidence-based rationale”

I will admit it…I am a nurse geek. I love researching articles and pouring over the information they supply. What I would like to do is start a collection of journal articles pertinent to the surgical oncology focus of my unit.

I chose number one and number two because I immediately recognized them as weaknesses and have already put effort into improving these indicators, and I recognized number three as something I am passionate about and love to do.

The evidence of my learning will be journals for number one and number two that outline my experiences specific to these indicators and what I learned from these experiences. For number three I plan to create an annotated bibliography that I can add to over time. I may even attempt to organize an online journal club for my unit.

Fortunately, this process is fairly second nature for me since we visited these indicators numerous times throughout my degree, and we even did an extensive and exhaustive version of this for my final focus practicum.

I still think nurses should be paid for this extra work…

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I stood up to the old, cranky, scary nurse on our unit a couple days ago during report following a night shift. A patient had TID insulin ordered 30 min. before meals. The computer had it scheduled for 07:00, 11:00, 17:00. Unfortunately our meals come at 8:30, 12:30, and 18:30. So, I reschedule the medication for 08:00, 12:00, and 18:00. As an extra bonus, the 7:00 insulin no longer fell on my shift and I would not have to check the patient’s blood sugar and draw up the insulin…but this was not the motivation for making the change.

The oncoming nurse was furious that I changed the schedule, since, according to her, the plan was to keep it at the original times. I pressed her for a reason (the first hint that I had more confidence…questioning her is grounds for a yellin’) over and over again but she could not give me one. She just kept saying, “It’s what I decided.” She called me lazy and accused me of changing the schedule so I wouldn’t have to give it.

But, I stood up to her and reminded her that it was ordered 30 min. before meals and for me to give it at 07:00 would be a med error…not to mention not safe. I explained to her that it had been drilled into my head over and over that insulin should be given right before a meal. My last instructor before graduating even insisted that patients had their meal tray in front of them and ready to go before I could give the insulin.

The cranky old nurse stomped away to grumble and complain about me. I went home proud of myself for taking a chance by standing for something I believed in…and I slept well with the belief that I was completely correct in my decision.

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Charlie went to his Bright Puppy classes earlier tonight. What a blast! He spent some time visiting with the other small puppies, worked on sitting and lying down on command, played in all different sizes/types of crates, and played on grooming tables. He has so much fun at these classes (ok, I probably have more fun hanging out with lots and lots of super cute puppies) and it mentally stimulates him into exhaustion!

We are still struggling to get him to go pee/poo on is pad. No matter how diligent we are (we’ve caught him in the act 100% of the time over the past week since deciding we were getting lazy and refocusing our energy), he just randomly picks a spot and goes. Ugh! I hope he figures it out soon. Even a little sign of understanding would be nice. There’s nothing like grown men running across an apartment with a still peeing dog in one hand and a bag of treats in the other…

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My sister had a baby girl a couple of days ago! She had it in the hospital I work in, right before I began my night shift.

YAY!

If you can believe it, I still haven’t gone to see the baby. I will be meeting her for the first time on Sunday at Easter dinner. I can’t wait!

Published by Sean on 03 Apr 2007

I passed!

A certain someone (specifically me) passed his licensing exams. He (meaning me) is a Registered Nurse!

I’ll admit it…I cried…

Published by Sean on 01 Apr 2007

Nursing in the News


‘ How much longe can I this u h er keep up?’
— William Shakespeare
Ottawa Citizen
01 Apr 2007

Sleep, nature’s soft nurse. Even after all these years, I still work night shifts. I probably could find a day job or an excuse to get out of them, but I’m not yet ready to say goodbye to the nights. However, on my evening drive to work along the… read more…