How was your day, Dan?

HONDURAS

I'm going on a nursing mission to Honduras, and here's the fundraising site.

https://www.crowdrise.com/HeadingtoHonduras

I don't have any fancy internet viral-video extravaganzas featuring celebrities dumping buckets of ice water on their heads. That may be to my disadvantage. I'm just doing this because I think it's a good thing to do.

Last year, some of my nursing school instructors went to Haiti on a medical mission, and I joined them to get a sample of what the experience was like. We set up our clinic in an orphanage. There is no place more depressing than a Haitian orphanage. Most of the kids had ringworm and, of course, intestinal parasites from drinking the water. And then we opened up to the local community, and that was just as bad. It was really sad, and frustrating, but the people were grateful for the little bit of help we were able to provide. And I ate goat, which was not as shocking as I thought it would be.

So this time I'm going to Honduras, which just as impoverished and perhaps a skosh more violent. Good times.

As fortunate Americans, I don't think there is any point in apologizing for our own lifestyles, affluent or otherwise. But we also need to be aware that there is a world around us. I, sitting at my computer right now, did not create the political and economic problems of Honduran society, but I can go there and use my skills as a Registered Nurse and help out a little bit. Just teaching them basics about health care, I can help a lot, perhaps.

Anyway--if you would like to donate to providing health care around the world, please give a few dollars. I will gladly take $1.

Thanks.

So You're Thinking Of Going To Nursing School, Pt. II

Let's get one thing straight: nursing is nursing. There aren't a lot of differences between the way a nurse one one floor cares for a patient than in any other part of a hospital. You assess your patient, you administer medication, you document what you did.

The working environment of each department is where the difference is felt. Choosing what type of nurse you want to be can be a confusing process, but it is important because it means what you want your work day to feel like. So to see where you fit in, here is a breakdown of four basic types of nursing available to new nurses, based on how they would fit into Hogwarts School Of Witchcraft and Wizardry from the "Harry Potter" series. There are other types of nursing than what are mentioned here, of course; oncology isn't included because that requires extra training, and pediatrics and neonatal are pretty self-explanatory for nurses who want to work in those areas. And also, I ran out of houses.

Want to see in which hospital department the Sorting Hat would place you? 

 

 

Hufflepuff: Medical Surgical, Med/Surg

Hufflepuffs are loyal, patient, kind, and they work hard.  It was claimed that Hufflepuff House would take any student, and that made it nothing more than a refuge for those who simply didn't fit in to any other house, but that perceived weakness is unfair. Hufflepuffs like being surrounded by lots of friends, they don't judge who you are or where you're from as long as you're good peeps, and they're happy for anyone to come hang out and chill with a butterbeer or two. It's a lot easier to get what you want when you're nice to people and you aren't ready for a fight all the time. (Perhaps this is why Hufflepuff House has graduated the least amount of Dark Wizards and Witches from Hogwarts.) But don't let that friendly demeanor fool you. Nymphadora Tonks was a Hufflepuff and she could kick your ass.

The Med/Surg floor of any hospital is where patients go when they don't have a specific problem to put them somewhere else. Med/Surg nurses handle a little bit of everything: infectious diseases, geriatric psych, alcohol detox, gall bladder removal, they've seen it all. They must be very thick-skinned, and the good Med/Surg nurses know how to smile through the chaos. That smile makes a big difference to the patients. Walking from a room where an elderly patient is sundowning and is trying to escape the hospital, and then going directly into another room with a patient with C. Diff. with uncontrolled diarrhea, can be emotionally taxing. But Med/Surg nurses must not only treat what ails their patients, but preserve their patients' dignity.

On a Med/Surg floor, you will run constantly and get yelled at from all angles, but you'll learn a lot about nursing, healthcare, and life in general. Just be ready, because it can be rough.

 

Gryffindor: Emergency Room, ER

Gryffindors are well-known for being adventurous and courageous, and are often looked at as being natural leaders. They won't hesitate to rush off to battle, ready to save the world, and they will do it all with great aplomb. And they're really good at what they do. Albus Dumbledore, Grand Sorcerer and all-around best badass wizard on the planet, was a Gryffindor. People love Gryffindor. Gryffindors are winners. 

ER nurses get all the excitement. Broken bones and gun shots, pregnant women in labor, all the action is happening in the ER. They'll run around the room and treat 10 patients at the same time, and remain totally calm while a patient is brought in by helicopter and is laying on a bed screaming in pain. Although don't be fooled — just as Gryffindors must endure taking classes in Ancient Runes and Numerology, ER nurses must also treat people who come to the Emergency Room with headaches and rashes. There can be long lags of those mundane patients before anything exciting is seen. And just as Gryffindors had to do a lot of homework, ER nurses spend a lot of time charting incoming patients and the many details of their health. Charting, charting, charting.

Things certainly move along fast in the ER. The patients don't stay there for long before they are wheeled away to the appropriate hospital department, so there isn't as much emotional bonding going on. But who has time? Next!

 

Ravenclaw: Ortho/Neuro/Trauma, or Tele

Ravenclaws are the intellectuals of Hogwarts. They enjoy learning just as much as they enjoy the competition of academic achievement. However, they are also fiercely logical, as they recognize that it doesn't matter how much anyone learns as whether a person knows how to use that knowledge. Sometimes Ravenclaws are a bit introverted, but it's just because they'd rather be reading books than playing with the stupid toys from Weasley's Wizard Wheezes. And they don't really care if you think they're nerds. They too busy being successful to care what you think.

The ONT floor is for more complex recoveries from bone surgeries, back/neck injuries, or other traumatic situations in need of intensive treatment. The Tele floor is for patients on telemetry, the system of electronic heart monitoring, who have perhaps had a heart problem or have even undergone cardiac surgery. These two departments are completely different in techniques used to treat their patients, but the ideology is the same. Care here is very complex, and nurses must perform lots of documentation and follow strict procedural guidelines.

Each pin site holding a bone together after any reconstructive surgery must be assessed and documented. The EKG strips of a heart failure patient must be constantly analyzed and interpreted, for the nurse to choose and administer proper medication. Each medication's intended effects and side effects must be known perfectly, to watch for any sudden changes in a patient's status. And those changes happen very, very fast and can be deadly.

Doctors aren't there telling the nurses what to do; the nurses must use their heads to know when a patient is healing properly, or when to alert the doctors that changes need to be made in a patient's plan of care. There isn't a lot of time for antics and goofing off when you're on one of these floors. But for those nurses who thrive in a situation of structure and well-defined expectations, ONT or Tele is a place where a nurse can make excellent use of his/her critical thinking skills. 

 

Slytherin: Intensive Care Unit, ICU

Slyterins are cunning, resourceful, ambitious, and independent. Some people think the Slytherins are difficult to work with, and it is true they can come off a bit frosty, but it is only because they are determined to do whatever it takes to achieve their goals.

Although they can sometimes be uninterested in being friendly, Slytherins really do have the best of intentions. Severus Snape is perhaps the greatest hero of the Harry Potter world, despite his scowling demeanor.  His critical diatribes against Hogwarts students were harsh, but Snape usually wasn't being mean; he just didn't sugar-coat anything.

Nurses in the Intensive Care Unit must be tough. On other units, a nurse works with support staff to assume partial responsibility for patients, but in ICU the nurse serves the patient one-on-one. They need to know how to do everything. These nurses must think quickly on their feet, they must be resourceful and entirely self-sufficient, and above all else they have no choice but to do whatever it takes to keep their patients alive. Everyone else, just get out of the way. ICU nurses don't have time for your nonsense.

It should be noted that when nurses on other floors need to accomplish difficult tasks, such as starting IV lines, they usually call a nurse from ICU to come help.

 

 

So You're Thinking Of Going To Nursing School?...

I am finally finished. After three years of taking classes, starting with A&P I because my pre-requisite courses from my first time in college were taken too long ago to be valid, through my final clinicals of nursing school, then taking the state boards, and finally navigating the "new grad" training program at my job, I am being turned loose to go to work. No more classes. No more safety nets. No more excuses. My first shift, on my own. For realz, with a pocketful of needles.

There are things I wish I had known when I started this process. Some things need to be learned on your own, but I will try to share my thoughts, to shed some light on the process perhaps for you, Dear Reader, who may be thinking about turning your life upside down and giving nursing school a shot as well. Ha. "Shot." Get it? Nursing humor.

1) There are nursing degrees, and there are nursing degrees. Once upon a time, nurses were trained at little career colleges, where young ladies learned how to bandage wounds and mix salt into water for 0.9% saline solution, and they walked away with an Associate's Degree and a nifty white hat (and, if they're lucky, eventually a wedding ring from a doctor). Those little nursing colleges are still around and they kick ass. Seriously, go to one of them and you'll be a really good nurse. But times change, the healthcare industry is changing, and hospitals don't seem to be hiring from those little colleges as much. What happened? Universities have created nursing programs on the Bachelor's Degree level.

Associate's or Bachelor's, you're still a Registered Nurse, an R.N.  You don't get paid more when you have a Bachelor's. It's just a title by your name, because you took some additional classes in leadership, community health, and nursing theory. It's a weird loophole — both degrees have the same license, so why bother getting the Bachelor's? Because hospitals get preferred treatment by Medicare if they have a certain percentage of their nurses with Bachelor's degrees, which means those nurses often get hired first.

Every hospital is different. Lots of hospitals prefer to hire people that they like, not just people with good degrees. But there will undoubtedly come a time, probably soon, when the Associate's Degree programs are simply phased out.

2) Check your school's accredidation. Anyone can start an accrediting agency. It doesn't mean that accredidation is worth anything. Most legit nursing programs are either NLNAC or CCNE. For example, those are the only two accredidation agencies accepted if you want to be a nurse in the U.S. military.

3) If you want to see what working as a nurse is like, get a job waiting tables at TGI Friday's. You run constantly, you have to remember a million things, people yell at you for no reason, your coworkers tell you things you need to remember while you are in the middle of doing something else and they make you lose your train of thought, there will always be people you can't please no matter what you do, and you have to clean up stuff off the floor. It can be chaos. If you can't handle remembering drink orders for a table of eight, you do not have the stamina to be a nurse. And getting two new patient admits at the same time feels EXACLY like being double-seated.

4) Compression socks. My God, they will change your life.

5) When you are looking for a nursing job, apply for jobs advertised as "New Grad." It is a specific job intended for people who just finished nursing school and don't have experience yet. Many hospitals refuse to hire below R.N. II, which is a nurse with 6 months or 1 year of experience. But other hospitals like hiring new nurses, because those new nurses can be moulded into the type of employee the hospital wants. The hospital will pair you with a preceptor for 6-12 weeks and basically put you through nursing school again.

6) Before you enter nursing school, or even while you are a student, if you can get a job as a Medical Assistant, or a Unit Secretary, or anything in a hospital where you have interaction with patients — not just a volunteer who delivers flowers — that will help you a lot in your job search. Work PRN while you are going to school. PRN means "pro re nata," which is Latin for "as needed," as little as a shift or two each week. Although Medical Assistants and Unit Secretaries are still specialized positions with skills involved, but that's another story.

7) It's okay if stuff about nursing grosses you out. You just have to fix your face for a few minutes while you're with a patient. You can hold your game face for three minutes. And the first time a patient, who is also someone's grandmother, looks at you with shame in her eyes because she couldn't make it to the bathroom in time, you will learn what it feels like to put aside your own worries and give another person some help.

8) ...and there are people who help you with some of that stuff anyway.

9) If a person asks you for Dilaudid, he/she is in pain. If a person asks for Benadryl after Dilaudid, he/she is having a problem with itching from the Dilaudid, which is a common side effect of the drug. If a person asks you for Dilaudid, and Benadryl, and Phenergan, the Benadryl and Phenergan together increase the high of the Dilaudid, and he/she is quite possibly a drug addict looking for a fix. How you handle it is your dilemma. You will have to make these decisions. If you cannot handle these decisions without passing judgement, you do not have the stamina to be a nurse.

10) I mean it about the compression socks.