Alphabet Challenge: W

I’ve signed onto The Blogging from A to Z April Challenge 2021.

The challenge is to blog the whole alphabet in April and write at least 100 words on a topic that corresponds to the letter of the day. 

Every day, excluding Sundays, I’m blogging about Places I Have Been. The last post will be on Friday, April 30 when I finally focus on the letter Z. 

W: West Catchment Area

When I started my job as a nurse practitioner in home care at a Veteran’s hospital outside of Chicago, I had the choice of taking care of patients in the north or west region. The north region was deemed a safer catchment area. The west region, which surrounded Oak Park where I lived, had pockets of crime caused by rampant gang and drug activity. I wanted to be closer to home and stop off for lunch if I was in the neighborhood. I didn’t think twice before choosing the west side. Maybe I thought I was invincible, a city girl used to the gritty streets and boarded up homes. 

I tried to keep my senses sharp and stay alert when I drove through the neighborhoods making my home visits. I kept my distance from the car in front of me in case I needed to make a quick U-turn. I avoided groups of young males loitering on the street corners and always locked the car doors. 

In the long run, it wasn’t just the neighborhood that proved unsafe. Any home I went into could hold danger regardless how dilapidated the outside environs. My close calls, and there were some, depended on the character of those with whom I interacted. 

Still, to this day, I keep my handbag on the floor of the car and out of sight.

Alphabet Challenge: H

I’ve signed onto The Blogging from A to Z April Challenge 2021.

The challenge is to blog the whole alphabet in April and write at least 100 words on a topic that corresponds to the letter of the day. 

Every day, excluding Sundays, I’m blogging about Places I Have Been. The last post will be on Friday, April 30 when I finally focus on the letter Z. 

H: Hospitals

I counted up all the hospitals I have worked in during the 40-plus years I have been a nurse. The total is 18. These are the hospitals where I was officially employed. That is, I attended an orientation, worked forty hours a week and received a regular paycheck. 

It doesn’t include the hospitals I visited as a nursing instructor when I had to review patient charts in order to choose appropriate student assignments. 

It doesn’t include the hospitals that I visited to enroll a patient in a home care program. 

It doesn’t include the community hospitals that I visited to evaluate the care that veterans received (I worked for the VA at the time).

So, I have been in many hospitals. Hospitals prompt a plethora of memories.  

The newer hospitals don’t stir up remembrances. They are disguised as hotels. Sterile. I suppose that’s desirable in reassuring patients and visitors that germs are kept in check. The older hospitals, to me, expose the nursing effort of caring for patients at a critical time in their lives—sometimes with success and sometimes with failure.   

I visited an older hospital in 2001, right before I retired, to enroll a patient in a hospice program. The hospital was a small community facility that had little renovation over the years. 

I needed to copy a form. The xerox machine was in the basement. I hiked down the stairway. On opening the door, humidity from steam heat, warm ovens in the kitchen and the noise of the washers and dryers immediately assaulted me. 

This was a functional basement of hospitals of long ago. 

Jolted by the sensory stimulus surrounding me, I trekked along the long corridor feeling as if I was twenty years old, wearing a white uniform, spotless white shoes and starched nursing cap held with bobby pins on the top of my head. My life in nursing, unlived, still ahead of me. 

Lost in nostalgia, I almost forgot to look for the Xerox machine.   

Overdue Reckoning on Racism in Nursing

Join me in attending this free series of timely web discussions: Overdue Reckoning on Racism in Nursing.

NurseManifest

We are excited to announce a series of web discussions “Overdue Reckoning on Racism in Nursing” starting on September 12th, and every week through October 10th! This initiative is in part an outgrowth of our 2018 Nursing Activism Think Tank and inspired by recent spotlights on the killing of Black Americans by police, and the inequitable devastation for people of color caused by the COVID-19 pandemic.

Racism in nursing has persisted far too long, sustained in large part by our collective failure to acknowledge the contributions and experiences of nurses of color. The intention of each session is to bring the voices of BILNOC (Black, Indigenous, Latinx and other Nurses Of Color) to the center, to explore from that center the persistence of racism in nursing, and to inspire/form actions to finally reckon with racism in nursing.

Lucinda Canty, Christina Nyirati and I (Peggy Chinn) have teamed up…

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Olden Days of Nursing: Dialysis

I still remember the teenager but not his name or how long he had been getting peritoneal dialysis (PD). I recall him walking between his parents down the long hospital corridor. He was going home to die. A father with small children had preempted the teenager’s spot on the dialysis unit. Restricting patients was necessary because supplies and personnel were in short supply at the time. Dr. Norman Lasker, head of the Renal Division made that decision unilaterally. 

I  had taken care of the teen when he came in for twice weekly treatments. His mother and father came with him bringing magazines with pictures of sweaty wrestlers, which I found repulsive. Not having any brothers, what did I know about teenage boys? However, we did have something in common: the new TV show, Batman. I would watch the show each week (no binge watching then) so when the teen came on the unit, we would have something to talk about. 

What happened to him after he was sent home? Hospice or palliative care hadn’t evolved, as yet. How did his parents manage? Did he wind up in a hospital at the end of his life? 

I called Carol Passarotti-Novembre. She and I worked on the same research floor: a 15-bed unit at Pollak Hospital in Jersey City. Carol was the first renal nurse in New Jersey, working alongside of Dr. Lasker in one of the first Dialysis Centers in the US in 1961. Only three other major Dialysis Centers existed then: Boston, Seattle and New York City. Dialysis nurses received on-the-job-training. 

Carol didn’t remember the teenager.

 

Of course, she wouldn’t since she had so many other patients. Some were on chronic PD, like the teenager. Patients came twice or three times a week, interspersed with emergency dialysis for acute problems like drug overdose, end stage renal failure, and post-surgical renal shutdown. For eight years, Carol was on call 24/7. Only once did she miss an on-call emergency. Another staff nurse from the research unit stepped in. The patient survived. 

Later on, Dr. Lasker was no longer the lone decider. Carol told me that a “board consisting of physicians, administrators, clergy and others reviewed potential patients to receive dialysis treatments.” She sat on this board. 

Carol ran the show at the Dialysis Center. The “Dialysis Center” was in reality four beds devoted to renal patients on the 15-bed unit. 

The procedure for PD was as follows:

After warming two-liter glass bottles of dialysis solution in the sink, Carol hung them from an IV pole. The fluid flowed into the peritoneal cavity and remained in the patient for 30 to 40 minutes. The bottles were taken down from the IV pole, inverted and placed on the floor so the fluid would drain back into the bottles, which took another 10 minutes. Repeat. The patients stayed overnight since each treatment lasted 36 hours. 

Carol managed up to four patients on Monday, Wednesday and Friday or Tuesday and Thursday. The day shift helped when we could. Evening and night nursing staff managed the PD during their shift. Carol discontinued the PD the following morning only to see the same patients come back the next day. 

Not surprisingly, Carol got to know her patients and their families well, as did all us nurses, since each patient came to the unit so frequently. 

One patient, Ellen, a slight Italian women with a large family, stopped breathing and became pulseless when I was in her room. I did what we were taught to do at that time. I slipped her on to the floor, struck her sternum with the side of my hand, breathed into her mouth and started chest compressions. The doctors on the unit came to assist me. We revived her. When she awoke, she told us she didn’t want to be resuscitated. We didn’t ask these questions in 1965. Happily, for me, when Ellen stopped breathing next, I wasn’t in the room. 

Carol had an uplifting story to share: 

“One of our patients was on PD for four years. Her local internist came to her home for each treatment, inserted the trocath [to make the pathway into the peritoneal cavity], and left. Her husband carried out each treatment. Even her little children helped with warming the bottles of dialysate. She switched to home hemodialysis for five years, then continued In-Center Hemodialysis for ten more years. At that point she received a cadaver kidney transplant, which lasted for a good number of years after.“ 

The following is from a speech Carol gave to nephrology nurses and technicians of North Jersey at Marriott Newark Hotel, Newark, NJ, May 6, 2011:  

“The role of the nurse has changed along with each modality of treatment, the changing needs of the patients and families, the advances in technology and the increasing demands for specialized education in nephrology.

. . . My knowledge of nephrology was ‘on the job’ everyday type of learning. I depended upon the physicians I worked with. . . .Working for the medical school had its advantages. The most important being able to be involved in research projects. e. g., vitamin studies, various solute clearance studies, cardiac output studies in the chronic PD patient and also, in developing the original cycler and starting home training programs for PD and hemodialysis.

 

(Carol was the first nurse to be included in a research study citation in the Annals of Internal Medicine.)

Today’s nephrology nurse is involved in direct patient care, teaching in all the fields: PD, hemodialysis, transplantation to the patients and their families as well as research and development. National and local organizations, such as American Association of Nephrology Nurses and Technicians were formed in order to ensure a high standard of education on both a local and national level and making nephrology nursing an accredited and recognized area of nursing. 

For me, the rapid growth and development in this area of medicine over the past 49 years, has been totally mind blowing, awesome, most exhilarating. The potential for future development is limitless!”

Carol married in 1968 and remained with the renal unit of the New Jersey College of Medicine and Dentistry Renal Division until mid 1969 when she left to have her first child. In 1971, she worked as a staff nurse in hemodialysis unit and later in the Hemodialysis Home Training unit at  Saint Barnabas Medical Center in Livingston, NJ. In 1976, she joined a Renal and Hypertension practice as both an office nurse and researcher in many drug studies. Carol worked  full-time, sometimes 50 hour weeks, before she retired in 2010 at the age of 70.  

After reflecting on Carol Passarotti-Novembre’s long career in nephrology, I ask the obvious question. How could the development of peritoneal and hemodialysis have progressed without the collegial partnership between nurses and physicians? 

Jersey Journal. Carol and Dr. Lasker are standing beside the first hemodialysis machine.

 

Home Visits Can Be Fraught With Danger

As I write my second book, which is about the home visits I have made over the years, I am resurrecting memories from my mind and the pages of my journals. Today’s post shows a time when I didn’t use common sense and how home visits can be fraught with danger. 

One day in early fall, on my drive back to the hospital after making all my scheduled home visits, I found myself passing by a patient’s apartment on the westside of Chicago. Since I was ahead of schedule, I decided to drop in, unannounced. I had the time. My patient had a caregiver: a tall, muscular man who always opened the door to the first-floor apartment wearing a long blond wig and thick make-up. Despite his flamboyant appearance, he gave competent care to his charge: a bed-bound, uncommunicative middle-aged man with multiple sclerosis. An exotic array of visitors wandered in and out of the apartment. My patient’s mother, strikingly average looking compared to the rest of the visitors, lived in rooms above her son’s and was often present when I came. However, this day I walked into an unlocked and empty apartment. Only my patient, lying in bed in the darkened bedroom, was present. 

Neither the caregiver, nor the patient’s mother, or anyone else familiar to me entered the apartment while I was there. However, as I finished with my evaluation, a man opened the unlocked apartment door. He wasn’t anyone I had seen before. My patient smiled at him knowingly.

The man removed his jacket and tossed it on the sofa. We introduced ourselves. His eyes moved down my body. Acutely aware of the precarious situation I was in—alone in that apartment with a strange man and unhelpful patient—a band tightened around my chest. 

“I’m just leaving,” I said as I promptly packed up my nursing bag. 

Safely back in my car, my breathing heavy and my hands shaking, I chastised myself for making this impulsive visit. No one back at the office knew where I was. It was a time before cell phones. What If something had happened to me?  I didn’t want to think of that. I never again made an unscheduled home visit. 

Sometime after that impromptu visit, at a nursing conference, I sat fixated as another home health nurse told a story about the time that she had made a scheduled visit. She rang her patient’s doorbell. He didn’t answer. It was later that she found out he had been murdered. And in hearing more detail, she discovered that the murderer had likely been in the house the exact time she was ringing the bell. Good thing the door wasn’t unlocked. 

Home visits can be fraught with danger. 

Nurses are nuts or do they just need “secretaries?”

 

Nurses Are Nuts by Anthony Langley, RN

 

 

 

 

Anthony Langley contacted me to ask if he could send me a copy of his book to review and possibly discuss on my Blog. I am always happy to support a fellow nurse who takes the plunge and writes a book about nursing, so I said sure.

 

 

 

About the Author

Anthony Langley has been a registered nurse for twenty-nine years. He also has a bachelor’s degree in criminal justice. His interest in nursing started after getting a job as a security officer in the emergency room of a hospital. A male nurse who worked in the emergency room showed him the things that nurses did, which got him interested in nursing.

Anthony Langley

He got his bachelor’s degree in nursing in 1990. At his first job, he started on a medical-surgical unit. He has worked in many areas of the hospital, which include surgical stepdown unit, surgical intensive care, same-day surgery, and the post-anesthesia care unit (PACU) recovery room.

 

 

Continue reading “Nurses are nuts or do they just need “secretaries?””

Just a Nurse

Reblogged from 10/25/2015

Nursing Stories

bookmrk-sm1This is from Suzanne Gordon’s Blog. Ms Gordon is a journalist and stanch supporter and promoter of all things nursing.

Recently she asked nurses to respond with their version of “Just a Nurse.” I am delighted to see their feedback. May nurses continue to tell the public what they do and how important their job is.

I would like to post all the ” Just a Nurse” submissions people have sent me.  See below.  What do you think?  I think they are all great.  Thank you so much, all of you.

Suzanne Gordon

I’m just a Pediatric Intensive Care Nurse. I just manage my patients’ drips to keep to their vital signs in a stable range. I just make sure their medications are safely administered. I just make sure the physician is informed of any small but meaningful change in their condition so we can work together to prevent…

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Can nurses really speak out too much?

This article caught my attention from the Nursing Times (a monthly magazine for the nurses of the United Kingdom). I had to do some homework to learn about The Queen’s Nursing Institute and its function.

Healthcare policy is a key activity for The Queen’s Nursing Institute. The QNI works to influence decision makers across England, Wales and Northern Ireland on health care policy including primary care, public health, nursing education, regulation and skill mix and issues such as services for homeless people and reducing health inequalities. To do so QNI contributes to stakeholder meetings, responds to national consultations, takes up issues raised by local projects where it appears they may have wider significance, and provides examples and information to policy-makers.  Wikipedia

At the annual conference of the QNI held in London last week, Dame Donna Kinnair, chief executive of the Royal College of Nursing, was told by government representatives that “nurses voices are too loud.”

Read her response below. 

 

 

Let’s Shout Together for Community Nursing

27 SEPTEMBER, 2019 BY  KATHRYN GODFREY 

Nurses at the annual Queen’s Nursing Institute conference held this week in London were told about the government response to hearing the views of nurses.

Dame Donna Kinnair, chief executive of the Royal College of Nursing, told delegates that she had been told by government representatives to bring her membership “under control” so that the voice of nurses would not become “too loud”.

“Nurses do need to speak out about key workforce issues such as safe staffing”

This conversation occurred at a government meeting, but Dame Donna reassured the audience that she would ensure the nursing voice would be heard and in fact “amplified”.

But can nurses ever speak out too much? As a profession they have traditionally been known for getting on with their essential work and not shouting about policy and resource issues. It is therefore good to hear that there is concern that their voices are getting louder.

Nurses do need to speak out about key workforce issues, such as safe staffing as well as more specific issues that affect the patients that they care for. For example, patients who are incontinent are often not provided with adequate supplies of pads to manage their condition. It is big issues like staffing and more specific issues like incontinence resources that affect the care nurses can give and the quality of life patients experience.

Nurses who do speak out can feel like they are speaking in a vacuum and that it is hard to get their message to the decision makers.

Now Dame Donna is asking nurses to share their experiences with her so that she can amplify and communicate to government the concerns of all nurses.

She said: “What I want to do is make sure your voice is amplified through my voice and I can’t do that unless you share your voices and stories with me.

“So that every time I look around, every time I speak to a minister I have got the basics of that conversation, so I am truly representing how nurses feel,” she told attendees.

“This is a crucial time for nurses to raise their voices and have their points heard”

“My pledge to you is that I will continue to amplify your voices and in return I ask you to share your voices and your stories with me, so that we can collectively be a unified profession.”

These are difficult times. We hear little other than Brexit in the news, which means key issues for the health and welfare of the population are being neglected. This is a crucial time for nurses to raise their voices and have their points heard.

The new advertising campaign We are the NHS is timely. The video about nursing is an excellent showcase for the many and varied jobs nurses carry out. It is a great illustration of how highly skilled and essential a workforce nurses are, the glue that holds the NHS together. So the more we hear from them the better. Let’s hope that those who need to listen don’t put their fingers in their ears.

nursing times

I wish our fellow nurses across the pond every success in making their voices heard.

Nurses Give Their Expert Advice on Understanding the Broken Health Care System

I have been on the lecture circuit. My topic is Empowering the Patient: How to Navigate the Health Care System. Two presentations down and two to go with another in the negotiating stage.

I’m fine-tuning the presentation based on the feedback I have received from my audience each time I give the talk. Sana Goldberg’s recently released book: How to be a Patient: The Essential Guide to Navigating the World of Modern Medicine has added an extra layer of emphasis on the importance of nurses’ influence in the health care system.

She writes:

 

I believe nurses are best poised to change the future of healthcare.

Today, registered nurses spend more time physically present with patients than any other healthcare professional, and as a consequence we see and hear a lot. We maintain a vantage point markedly different from that of the MD, the scholar, the journalist, and the policy maker. We are intimately familiar with the complexity and multiplicity of the patient experience, as well as the systems in health care that fail to acknowledge it. We witness the system’s barriers regularly, and in turn we come up with creative solutions to side step its most vexing realities.

(Sana Goldberg, How to be a Patient: The Essential Guide to Navigating the World of Modern Medicine, page XXIV)

Doesn’t that last sentence remind you of Teresa Brown’s New York Times Op Ed essay that I posted just last week? Side stepping vexing realities is another way of describing the “workarounds” that Brown described.

I’m using another book written by a nurse for my talk. Finish Strong: Putting Your Priorities First at Life’s End by Barbara Coombs Lee, who besides being a nurse is a lawyer and President of Compassion and Choices.

Both books are well written and easy to read and full of great information that older readers will find helpful. And, of course, I am pleased that they are written from a nursing perspective.

How Mindfulness Can Be an Act of Self-Care for Nurses

I recently came across a new, to me, Blog: Nightingale. A 2017 post by Teresa Brown describes her initial exposure and reservations about mindfulness—I am not giving away the ending. Given I had just spotlighted Julia Sarazine, a qualified mindfulness instructor, I decided to reblog Teresa’s essay.
The Nightingale website looks interesting and promising, however, I didn’t notice any recent activity. Sara Goldberg, founder of Nightingale, may have been busy with her new book: How to be a Patient: The Essential Guide to Navigating the World of Modern Medicine, which was recently released. I read her book and will review it in a future post.

Nightingale

Nurse Burnout Won’t go Away Until the Industry Changes. But in the Meantime, Mindfulness can Help Nurses Prioritize Their Well-Being.

suzy_4

This past November I attended a workshop on nurse burnout at the Johnson Foundation at Wingspread in Racine, Wisconsin. Clinical nurses, administrators, and researchers came together for three days to discuss this pressing issue that is epidemic in nursing. One survey found that almost half of nurses are burned out, meaning they’re so overwhelmed by the job that they’ve lost the capacity to really care about it or their patients.

I tend to be suspicious of talk about mindfulness in health care because it seems to place the onus for change on individuals instead of the overall system.

Several of the workshop presenters discussed “Mindfulness” as a way to alleviate burnout. I tend to be suspicious of talk about mindfulness in health care because it seems to place the onus…

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