Category Archives: Nursing

Psych

No joke, it’s true. I’m a psych nurse. I retired once and returned to nursing full time within two years. “Why?” many asked. Lots of reasons,  and a topic for another day.  “But you’ve not done this before,” friends and family commented with concern. I admit I felt pulled and challenged to commit to something I once feared.  Good news, It’s going well and I really like it.

It’s been nearly a year working in a state hospital with severely mentally ill patients.  The vast majority are lovable in spite or because of their illnesses.  There are many terrific people who work in this system. I need to write about it as a way to process and take care of me, to increase awareness and reduce fears about mental illness and hopefully to inform and entertain.  Characters, events and tales are fiction and any resemblance of actual people, places are coincidental.

Psychiatry was the last rotation of my nurse training decades ago. I hated it!.  I found the location and  patients frightening, and the staff callous and as damaged as the patients.  The instructor, Mrs. Castle was spooky with a flat facial expression and Mona Lisa smile. Therapeutic communication seemed inefficient and vague.  At the time, Castle offered two memorable lessons:  the benefits (soundless steps)of her crepe-soled shoes and the importance of coffee to stimulate a well timed and formed BM in the AM.  Stick with me people, nurse stories often discuss seldom spoken topics.

In spite of my resistance, fear and arrogance, dang Mrs. Castle pounded in a lot of learning, techniques, and communication tools that have sustained me throughout my nursing career.  So there’s a big lesson here that I have tested repeatedly and almost always continues to amaze. Fear and resistance guide to the exact challenge that should and can be faced.  It never fails to teach or guide me to where or whom I need to know.

Why would a grey haired grandma on Medicare go back to direct patient care in an antiquated facility, with some of the sickest mentally ill?  A Psychiatrist that I hold in high esteem suggested that she could see me working with this population. It was as simple and direct as, “I think you could do this.”  Secondly I prayed about where I could be most useful.  Finally I am at a point in life that I have a heart that is both tough and soft enough to love those seen as marginally loveable or lost.  I laugh it off but also believe this period will be my Mother Teresa years.  Psych nursing can be less physically demanding and a good fit for those who move a little slower than yesteryear.

Applying and interviewing for work can be intimidating.  Heck, getting someone to take a look a 40 + year work history is nearly miraculous.  The old rule about, it’s who you know, or using your contacts to grease the wheels still holds true today in my experience, at least to open a door or getting a call.  Well obviously I got the job. My husband thought I had lost my mind…………more on that later.

Competing Hemispheres

Left Brain Report
To: Nursing Manager
1. Washer is unplugged and non-functional. Based on the electrical burn odor I suspect the motor is ruined. Reason: overfill and industrial use of home style washer.
2. Budget Justification: Replacement of appliances, mattresses, bedding and supplies necessary to care for growing number of patients who are incontinent not anticipated during budget prep.
3. Room changes and care plans altered to reduce incidents named above. The psychiatric conditions of our patients minimize success of patients’ understanding to participate in changing behaviors.
4. Nelda is exhibiting new behaviors the team may want to address.
Thank you.

 

 

 

 

 

 

                                                                                                Right Brain Report

Urinary Spring Floods
Another One Bites the Dust- Washer, NOT patient. The washer in laundry room (nearest D3) sustained a slow burn when Freida Frequency’s saturated bedding and wedge pillow overfilled its drum. The washer was reported as not working and our noses detected the tell-tale scent of electrical and metallic burn. Said appliance was unplugged on 6/1/18 at 0800 and a brief prayer of gratitude that St Florian, patron saint of fires, was unnecessary as the once fierce agitator’s time of death was confirmed. Nurse Evelyn completed a work order about the washer’s demise.
Frieda’s mattress was replaced in the last 3 months. The new one is likely saturated given the volume of urinary exposure and the tributaries pooling beneath and around the Isle of Frieda.
Darrel Bellow’s bathroom habits are not fully understood except for the following:
• He has URGENCY and Frequency of both bladder and bowel (based on hallway sniff test).
• Locked bathrooms are a huge barrier for a man of his age.
• He is unwilling to allow ANY medical intervention
• His bedroom’s bathroom is green-locked (closed) for an unspecified time for repairs.
• He occupies the Community Bathroom so often thus delaying other’s use

Nelda Border regaled evening staff with a new behavior as proof of her dire medical/medicinal needs and aptitude for drama and attention. She lay face down on the floor of her bedroom (no fall was involved) urinating all over herself and the floor. She laid amid her custom tidepool until she tired of it. Finally retiring and going to bed in trade for some Benadryl. Staff wisely downplayed the entire scene and cleaned up the mess and laundry as though no big deal.
That’s all Folks,
Ima Story, RN

Walking Wounded Caring for Patients

RN01100713_p12_300x

Healthcare and healthcare workers of all disciplines are weary, under appreciated, fearful about the overwhelming responsibilities, liabilities and lack of security. Patient acuity and volumes are high. Nurse to patient ratios in many places are unrealistic. It is stressful, raw, gritty work regardless of all the shiny, electronic and adaptive tools. Healthcare is still a wonderful, miraculous, important calling. I believe it’s imperative that we help the on the job warriors to heal themselves and their work groups. Continue reading

Response to Dirty Little Secrets in Mighty Nurse

We are only as sick as our secrets and our secrets keep us sick. Working conditions in healthcare are less than optimal.  I think we need to move beyond the grief and resentment and figure out some actual solutions. Without reimbursement, there will be less healthcare, technology, and intervention.  Additionally we each are responsible for our attitudes and actions.

Perhaps it is time to capture the attention of the general public with a massive, advertising campaign teaching them how to give healthcare glowing satisfaction scores. We need a Mary Poppins affect of a spoonful of sugar makes the medicine— the tough stuff, pain, impairment, economic losses of illness separate from the care to address it.  Maybe subliminal messaging embedded in TV’s, EMRs, waiting and family areas, hallways and cafeterias about the wonderful world of healthcare similar to a Disney ride would make everyone happier. Continue reading

Wounded Warrior Notes Delivered

I saw a Facebook post about writing to Wounded Warriors at Walter Reed Medical Center before the holidays. My reaction was I CAN do THIS. Later that day I finished some hand crafted cards and wrote half a dozen cards. I invited my husband to join my effort and he wrote a couple. We both felt good about doing this. So I posted a challenge to my FB friends. Robin and Elizabeth took the bait and began writing. Each of us experienced joy and satisfaction from these simple acts.

A few weeks later, one friend and then the other said their notes had been sent back to them as undeliverable. Sure enough ours came back too. Having heard my friends’ disappointment I chose a different reaction. I saved my cards and thought, there’s a Veteran’s hospital in my city. I bet they can use these.

I visited the local VA hospital on my tiny mission and got so much more than a bargained for. A window of time on my schedule opened up unexpectedly giving me just what I needed to accomplish this task. (More about that later) Being a nurse gives me a lot of familiarity with the inside operations of healthcare and removes many barriers experienced by those unfamiliar. I felt certain VA would have a spiritual care program. That was my target.

I was efficiently directed to the chapel and the Chaplain Services office. I briefly explained that I had cards and wondered if they may have a use for them. I was treated graciously and the chaplain explained how they likely could be used. He showed me their chapel and offered more opportunities for service. The chaplain was trying to get a fix on my purpose, motivation, and connection. He became more suspicious when I asked to do a quick video of the two of us. He asked, “How are you connected?” This perplexed me slightly. I replied,” I’m a citizen interested in kindness.” I left with a big smile on my face.

As I said earlier this little side trip revealed many things to me. But for this story on note writing to veterans teaches me four things.
1. Being selfless without attachment to the outcome produces internal joy and can be shared.
2. It’s easy to be moved to act on behalf someone/thing exotic, foreign, or well recognized-
often that same need lies within my midst, in the same city, maybe even right next door.
3. Little adventures can lead to opening senses to endless possibilities and opportunities.
4. No act of kindness is wasted.

VA 1 VA 2

Book Review

Possible blog photos Mar 25,2013 021book
My Last Step Backwards is a great title and good advice in a world encouraging constant self improvement. The beautiful woman on the cover is, quite literally, a beauty queen. Author Tasha Schuh is well educated, young, glowing, is full of possibility and promise with a radiant smile. Like many a gift, this is the pretty packaging. Inside reveals devastation and triumph.
Are you are drawn to life-altering drama, perils that overwhelm the imagination and surprise endings? My Last Step Backwards reveals much about modern day family life in a small Midwestern community, aspirations of youth and emerging womanhood. But the real story is of grit, determination, love and a very deep faith. It broke my parent heart. It made me feel admiration for family, friends and healthcare providers. It shattered some of my own beliefs and experiences as a nurse.
I ached for the periods of delirium, depression and utter fatigue. I was humbled again and again. I learned that I have much more to learn about faith, focus, grace and gratitude. What most people see when they meet Tasha is her losses. Tasha Schuh is a C5 quadriplegic due to a fall through a trap door preparing for a high school production.
The fact she alive is a miracle. Amazingly she describes ‘being saved by a disaster.’ Tasha is not just alive, she is vibrant, on-the- go, and educated. She is a professional inspirational speaker who shares her journey and its lessons. She drives. She inspires. She loves, laughs and worships. Tasha is a very public personality and has written this book.
Tasha Schuh makes the world a better place and anything is possible. Read her book. Hire her to speak. Get inspired. Become her student for she is wise and wonderful.
TashaSchuh.com tasha@TashaSchuh.com Facebook/TashaSchuh99

Code Blue

“Code Blue. Riley Children’s 1st floor lobby. Code Blue. Riley Children’s 1st floor lobby,” was announced overhead. My colleague and I continued walking toward our destination as though nothing had happened but I was no longer completely in my body. I offered a prayer for the patient, the family, and the healthcare team responding.
The chill of that code blue lingered in my thoughts. It jarred the peace and calm I have come to enjoy in my life beyond the walls of a hospital. It made my heart hurt because it was at the children’s hospital where kids already face situations that bring many of us to our knees. It had me thinking about the operator who made the announcement, the parents and family and the patient’s outcome. I almost felt I’d heard this code with new ears, perhaps like many patients and families.
Next time I hear “Code Blue” I will stop momentarily as a sign of respect to offer a prayer. I am grateful for those who work to care for, heal and some days even save lives. I am thankful for a new perspective.

Ugly Mean

Ratched3ratched2ratched1

I have been the villainous Nurse Ratched more times than I care to admit. Efficient, superior, and unbending. I have exploited power by harshly enforcing those deal-breaker “policies” like Visitation 600.29 when it suited me. I have been demanding and downright intimidating to some coworkers. I did all of this under the immature guise of leadership. These behaviors served me. I was given more responsibility, known as a dog for the details, an agent of change. I can’t help but wonder how many nightmares was I the monster or the topic of employee’s therapy sessions? Continue reading

Unexpected Gifts

IMG_0924
People will forget: what you say, what you do, but never how you made them feel- Mother Teresa

Several years ago when our youngest graduated from high school, we combined efforts with families of a niece, a nephew and another shirt tail relative to host a very large outdoor party for the four grads. Our boy Nate had attended a different school than the others so there were quite a few people we didn’t know. Early in the afternoon under the food tent, a guy, I presumed to be a classmate’s parent caught my eye, engaged my attention and waved. I waved back and smiled. Continue reading

Band-Aids

band 4Nothing is as useless as a band aid that won’t stick. You know the ones. The off brand deal that sat in a drawer or first aid box too long, maybe more thought went into the packaging than the product. But a band-aid that covers and sticks can be magical. It can be a minor tourniquet, a protective cover, a badge of honor and with the right decoration even better than a loved one’s kiss.band (2) They can keep the dirt out, buffer a scab and even dispense a medicine. Band-Aids are supposed to help healing and protect, to make things better.
Band-Aids can camouflage a bruise, tattoo or a hickey. Sometimes, Band-Aids act as co-conspirators to a lie or two. For young children they can be miniature magic carpets for attention, imaginary events, and perhaps early stimuli for story- telling.band 3
I see Band-Aids as metaphor for nursing and nurturing . How about you? I’d love to know.
Do you have a Band-Aid story to tell? Please do.