My first nursing convention

By the time this blog posts I will have gone to my first nursing “convention”. It’s a one-day event sponsored by my hospital but it is a whole day of speakers and learning related to leadership in nursing.

It’s actually meant for nurses already in a leadership positions but being a leader is something that interests me and I would like all the help I can get. I want to become someone that other nurses can look up to. While I don’t really plan on managing a unit or anything like that, I do plan on obtaining an advanced practice degree and I want to be a leader in whatever field I decide to go into. I have worked with and under great leaders and I have worked with people in leadership that I wanted to stab in the eye with a pencil (I have been a mental serial killer quite a few times!) I don’t want to be the person that someone else wants to stab in the eye lol!

I don’t feel like leadership=management position. Leadership, in my opinion anyway, has more to do with the person and less to do with the position. Some of my coworkers have been amazing leaders. Whether we have two codes going on simultaneously, admissions and discharges back to back, a super sick patient that is trying their damnest to circle the drain, or my personal fave: the wife and girlfriend trying to visit the trauma patient, there have been nurses that I worked with that immediately jumped in. They took the lead in the situation and helped turn chaos into control. I will say that in my experience most of those in management would have floundered in those very same situations. If you think about it, it is far easier to manage people than it is to lead them. You can’t be a leader while simultaneously saying “do as I say, not as I do”. At that point, a bad precedent has been set. I feel like a leader is going to search for the right way to do things and if they don’t know the correct way, they have no problem asking others for help. Leaders can provide positive feedback but also know how to provide constructive criticisms. The managers I have typically come across seem to be able to do one or the other, rarely both. That’s not to say I haven’t worked with management that wasn’t super badass. I will never forget one manager, Ron. He seemed so intimidating until I actually had to escalate a situation up to him. Long story short, I was working under “leadership” that wanted to be on a friendly basis with the team instead of lead the team. A certain situation continued to occur that ended up slowing patient flow. The supervisor didn’t want to step in because they didn’t want to hurt feelings. Well, you know me, I escalated beyond them to management. I remember exactly what he said to me when I walked into his office to complain “Shaunelle, don’t come to me with a problem without a solution.” We spoke and surprisingly I had a solution in my head without even realizing it.

His words changed how I handle situations to this day.

To me, that’s leadership. I want to be like that one day. I want to be able to not only provide solutions for my team, I want to encourage others to find solutions for themselves. So, off to the nursing conference I go. Hopefully next week I can come back and share some of what I learned.

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Decisions

I think I finally made my decision about going back to school. I completed my bachelor’s degree last year and have been on the fence about getting my master’s degree. Is it worth it? What path should I take? I just couldn’t make a decision.

I think I know what I am going to do. I’m going back to school.

At first, I planned on either following an education or leadership path. I think that is going to change. I’m going to try to get into a nurse practitioners program.

After talking to lots of other nurses that are currently in school, nurses with their master’s degree already, and lots of research, I realize my career path is far more flexible if I have my advance practice degree.

I think I stayed away from the idea of an NP program because I had a very narrow idea of what nurse practitioners can do.

My views are changing. Being around a lot of wonderful NP’S in my career had shown me they do a whole hell of a lot. NP’S make a difference. I want to make a difference. I think I’m going to really give this a shot…

Almost on time

We have all worked with that one nurse that is almost but not quite on time. You know the one, they come in about 5-10 minutes late, they still need to go put all their stuff away, they still need to get their coffee (or they come in with their Starbucks cup and now you know why they are late), they need to get their report sheet, they stop and talk to other people, and they need a moment to complain about their assignment. It’s like 7:15 before they get to you. Meanwhile, you just had the shift from Hell, missed lunch because your patient couldn’t decide if they were ready to die or not, and you just want to go home.

That nurse drives me nuts!

I hate being late to work (though I am late just about anywhere else) because I know someone is waiting for me to arrive. I just think it’s rude. I do understand, however, that crap happens and sometimes being on time is just not on the menu that day. I get it, really I do. But that one nurse that can never seem to make it on time? Yeah, I don’t get that. I also don’t understand how they can walk in late and then still take their time getting report!

Yeah, no.

There are ways to deal with nurses like that.

When I knew I would be giving report to a certain nurse I would go ahead and write my report out. I mean, I would write a report that my nursing instructor would be proud of. As soon as they came rolling in (10 minutes late of course) I would catch them. “Hey I wrote out my report, I will be in the break room getting my stuff if you have any questions.” This was typically met with a blank stare but I really didn’t care. Now, I didn’t do this with every nurse that was running late, just the one(s) that I know are like the one I described above. I dont have time for the foolishness!

If I didn’t write out report I still caught them as soon as they made it onto the floor. No they aren’t stopping and talking to another nurse. No they aren’t going to stand and complain about their assignment. No I don’t want to hear about why they were late (yet again) this time. Not today buddy! When they hit that floor they are ready to go in my eyes and I am walking up, cutting right into whatever nonsense conversation they are having, and letting them know I am ready to give report. Glare, stare, I don’t care. I am done with my shift and it’s time for me to go.

If you are that nurse, the one that strolls in late and then takes your time coming to get report, I hope you finally get written up. I hope one of your tires is flat when you get off work. I hope Starbucks runs out of every flavor of coffee that you like. I hope that your patient has to has every scan possible and you have to travel from procedure to procedure all day. I hope your new admision is a hot mess.

Oh, and I am not back so you are going to have to give report to a whole new person…

Yep, I’m petty like that.

I’m a nurse, and the worst patient

I am a nurse. I am very proud of that, I mean, I have a whole blog dedicated to being a nurse!

However, I am the worst patient.

Lately I have had to be a patient far more than I want to be. (Here is a link to my blog post on why I have had to be a patient frequently.)

I don’t know how to stop being a nurse and sit back and be the patient. I don’t know how to shut up and listen. I want to talk. I want to tell the doctor what I know. I want to be in charge of my care. I want to be the nurse.

I don’t like not running the show when it comes to my own care. However, this situation is aggravated by the fact that I don’t even know what is going on with my health. I feel completely helpless… and humble. I now understand the fear my patients have when they are coming to get scanned. As you all know, I work in radiology and a majority of the patients I work up are there to get scans to either see if they have cancer or to see if their cancer has spread. They are coming in dealing with the unknown. The fear, the anger, the tears, the blank stares, I understand why my patients exhibit so many emotions. It’s the unknown. I am going through it now and I am pretty sure I have gone through a lot of those emotions. I am blessed to not have cancer but having to go from seeing a family doctor, to a pain specialist, and now to neurologist, all because I have spreading neuropathy is scary. I don’t know what is wrong with me and as a nurse that drives me nuts.

I am a nurse, I help people get as healthy as they can. My job is to literally fix people and yet here I sit unable to fix myself because I don’t even know what’s wrong. I feel so helpless. I want someone to say “This is what is wrong and this is how we fix it”. I want to fix myself like I fix everyone else. I want to nurse myself back to health.

I don’t even know where to begin so friends I ask: do you have any suggestions for not going crazy as I work through this?

Dear administration

Dear hospital administration,

Hi, I’m just a lowly nurse here in your hospital but may I make a suggestion?

Please, PLEASE include the staff that will be working in a new area in the design of that new area!

I know you think you, the architect, and the contractor know what’s best but you don’t. YOU DON’T. You all look at what looks good. I mean, everything looks great on paper. What you aren’t paying attention to is whether or not the area will function for staff.

I cannot tell you how many times I’ve walked into a new area and immediately started picking out what doesn’t work, what needs to be moved, and what needs to be completely redesigned. I’ve seen areas opened and then closed so it could be “remodeled”.

Stop it!

You could save money, time, and stress by doing it right the first time. Let us be a part of the planning process. Let us be a part of the “walk through”. Talk to us and find out what we do and don’t need in the new area. Talk to US! It will benefit everyone in the long run, I promise…

The kids are alright

This is my last week of shadowing in the PACU. I’m ending my week in pediatric pre and post op.

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I have been a grown up nurse my whole career. Med surg, small ICU, STICU, that’s what I know. I know how you fix an adult. I know nothing about children.

I am not good with kids. I’m uncomfortable around them. I’m not used to kids. I am out of my element.

I feel so freaking awkward!

I am so useless in here. It’s not because the nurses aren’t teaching me. The PACU nurses have been amazing. I just don’t know how to handle kids. I have none of my own. I don’t want any. I have no maternal instinct. I have little patience for crying. I’m just not good with kids and I’m well aware of that.

So here I sit, on my phone, typing up this blog while on lunch, hoping I survive a few more hours so I can go back to my adults in radiology on Monday…

OR 4

I’ve been shadowing in the pre and post op unit for the last week. I am still a radiology nurse but I’m up here learning a few things. In MRI we give some of our patients propofol to sedate them so they can tolerate the scan and then we recover them afterwards. My department has me floating in PACU to evaluate how PACU recovers patients to see if there are things we need to bring back to our department. I’ve been enjoying myself so far. Today I am following the sedation nurse. We are in OR 4.

OR 4 is where they are doing all the abortions today.

I wasn’t prepared.

I have no children and have never been pregnant. I have no desire to have kids. Honestly I’m not fond of them. I am pro-choice. I consider myself pretty liberal. I don’t judge women who choose to have an abortion.

I was still not prepared.

I’ve read about abortion. I know people that have had them. However, I have never actually seen an abortion and after today I don’t need to see anymore.

It’s emotional.

One was because of fetal deformity. Most were not. The reason didn’t matter. You could see the anguish in some of the faces of the patients. Some were stone faced and I couldn’t really tell how they were feeling. A 16 year old seemed not to really have a full grasp of what was really happening. One lady cried and expressed her feelings of guilt the whole procedure.

It’s was a lot to deal with.

The procedure itself was different than I expected. Mentally I has to steady my nerves to watch how the fetus was removed. Typically I stayed at the head of the table with the patient for their comfort… And my own. I tried to focus on the patient and not the procedure so I could keep my emotions out of it.

This is definitely something I could not do on a regular basis, if I could ever do it at all. This experience is something I definitely won’t forget.

I still remain pro-choice even after today. Now I understand what women go through not just physically but emotionally when having to make this choice. It’s so much deeper than what I understood.

The complainer

Don’t be the complainer.

You know the one, nothing ever goes right for this nurse. They are the ones that come in and start complaining before they even clock in. They always have the worst assignment. They always have the worst shift. Everything is always wrong.

Two total care patients that only really need repositioning? “OH MY GOD WHY DO I HAVE TWO TOTAL CARE PATIENTS????”

Four walkie talkie patients that are self care? “GREAT THEY ARE GOING TO DISCHARGE SOMEONE AND I’M GOING TO GET AN ADMISSION!”

Float to an easy unit with cool ass staff? “WHY IS IT MY TURN TO FLOAT???”

Go home.

Why are you even here? Why are you even a nurse? What did you expect from the health care field? No, our jobs are not a roses and sunflower fields every shift. Sometimes our jobs suck, horribly. Honestly though, if every shift is your worst shift ever and it’s like that no matter where you work… I hate to be the bearer of bad news but it’s not the job, it’s you.

I mean, you’re the common denominator here. It’s time for you to face the facts: you’re miserable at your job because you’re just miserable as a person. Maybe you should work on that…

Preceptor behavior (how not to be an asshole)

I have been the orientee and I have even done a little precepting. I lucked out so far and had wonderful preceptors (except for one but anyway…) but I have seen some TERRIBLE preceptors.

One thing that I noticed from a few of the preceptors that I would definitely label as “assholes”, is that they take pride in being intimidating to their orientee. I have¬†witnessed this behavior and have had other nurse confide in me about their preceptors after they were out of orientation. Some of the things I heard were appalling.

It is NEVER okay to make your orientee feel “dumb” or “stupid”. You were a new nurse at one time and you didn’t know everything when you started, you had to be taught as well. You know what else is not okay? It’s not okay to just leave your orientee to fend for themselves. You are not on vacation, you are responsible for teaching this new employee the ways of your unit. Get up and check on them, make sure that they are actually alright. STOP USING THE AMBUSH TECHNIQUE!!! For those of you that don’t know what the ambush technique is, let me fill you in on this bs. Basically what happens is the preceptor ambushes the orientee when they aren’t prepared for it and starts hammering them with questions of “things they should already know” in the eyes of the preceptor. Do I know the normal range for a CVP? Yes, I do. Do I know the normal range for a CVP when you show up out of nowhere,¬†while I am catching up on charting¬†on a patient that I just had to start on norepinephrine and give two units of blood? No, absolutely f*****g not! This does not mean I am less intelligent than you, it means I was focused on my charting and not expecting a nursing ambush! The ambush technique neither proves nor disproves someone knowledge, it just makes you look like a douche. While we are at it, stop making your orientee feel like they are bothering you when they ask you questions. They don’t know. You do. Spread the wealth of knowledge. Learn how to give constructive criticism¬†and praise. A lot of preceptors seem to miss that last part. Your orientee is already paranoid and trying to be a close to perfect as possible. Let them know you notice the good things they do along with the things they may need to work on. Your orientee will be much more receptive of your criticism, trust me.

Look, i’m not asking for a lot. I am simply asking you to remember what it was like when you were orienting. Remember how stressed you felt. Remember how confused you were. Remember how intimidating it was. Remember that you aren’t perfect.

n00b

So you’re the newest person on the unit. You may not be new to nursing but you are new to this place. Don’t let that freak you out.

As the newbie I was always really quiet and reserved. What I didn’t realize was how off-putting that was to others. It never failed, once I got to know my coworkers they would all say the same thing “I thought you were so mean when I first met you!” For the longest time I didn’t understand why that seemed to be the case. You know me though, if I don’t know then I’m going to ask. That is when I found out that I sort of appeared unapproachable because of how I tended to distance myself from my new coworkers. I changed that once I started the new position I am currently in.¬†This time I made a conscious effort to get to know my coworkers.

Here are a few steps to transition into your new work environment:

  • Introduce yourself to your new coworkers. If you know of a good ice breaker then use it (having the name Shaunelle but being called Fred is one hell of an ice breaker, everyone loves the story of how I got my nickname.)
  • If you are an experienced nurse understand this: your experience is much appreciated but you are the new nurse¬†on the unit. Don’t walk around like you already know everything there is to know. You may know cardiac ICU but you don’t know how they run¬†their cardiac ICU. Have a little humility (ran into this with a new coworker, she didn’t last long).
  • Don’t be afraid to ask questions. It is safer to ask than to¬†assume you know what you are doing and then do it wrong. Your new coworkers will remember that screw up, trust me.
  • If you are a super proactive person, join one of the committees. You are bound to meet your coworkers that way.
  • Become familiar with your physicians and introduce yourself to them. Let them know you are new to the unit, I mean you will be working with them too.
  • Know that not everyone is going to warm up to you immediately and that’s okay. They may still be “feeling you out” so to speak. That is not your problem, that is theirs. They’ll either come around or they won’t. It’s not the end of your world. However, DO NOT allow bullying behavior towards you. You may be the newbie but you deserve respect and if they want it from you then they should earn it. Forget that “nurses eat their young crap”!

Those first few weeks, hell even first few months, are a weird time. You’re trying to adjust to a whole new setting. Things may feel off and that is normal. You may feel a little out of place at first, and that’s normal too. Give yourself time to get acclimated to your new surroundings, you are going to do great!