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    L Jane Acree

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Should Nurses Have to Be All Things to All People?

You have what it takes

On being all things to all patients – and some tips to getting through the shift in one piece.

So needy – Why is it that patient’s emotional needs can wear you down faster than their physical needs?

Super-size me – And don’t most patients want you to pile on the time, service, and sweet-talk all the way to the ceiling? Plus they think you should know every latest about their case.

On any given shift, a typical patient mix will be extremely diverse. And patients’ emotional needs are as varied as their diagnoses.

Here’s what experience taught me -

You’ve got the stuff – It can be done – And you are well able to make each patient happy when you set your priorities and communicate well. Even new nurses are well-received and respected when they are open about needing advice occasionally.

Comprehension is key – I found out that the quality time I spent with the patient, early in the shift, made all the difference. When patients truly understand their plan of care for that day – what to expect from all the disciplines and their own role – they relax more and their compliance increases.

Share the love – When your patient understands who does what, they call for you less often. Make sure they have the phone extensions of their CNA, social worker, RT, the kitchen, business office, and the like. Give this information in a positive way that empowers them.

You are brilliant – You graduated college and passed boards. You are a professional in a well-respected vocation. You have a good heart. You serve others to the best of your ability. Most patients, whether or not they ever tell you, appreciate your work and how you made them feel.

They don’t define you – Those patients who do not appreciate you are usually too caught up in their own problems to appreciate anything outside of themselves. So don’t be concerned if they complain. They are defining themselves – not you.

So, can a nurse be all things to all patients? For the most part – yes, you can. And you can do so without hurting yourself. There will always be the exceptions; but as long as you look and behave as a professional, you will be considered as one. When you stay focused, organized, and compassionate, you win their confidence. And their decrease in fear makes a big impact on their speedy recovery.

Next up is the story about the death-CNA. This one will freak you out.

But for now, here’s something that will make you laugh out loud! ”Only A Nurse Could Laugh at This…” – Funny Stories and Quotes from Real Nurses for When You’re Having “One of Those Days”

Cheers!

9+ Ways to Deal with Mean Coworkers

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Mean Coworkers
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At work, nurses need each other. The stresses of the day need an outlet that only somebody in the same trench can understand. But what choices do nurses have when a coworker makes your shift feel worse instead of better?

You know – that coworker who almost always snubs you, criticizes you, and acts like they are better than you. What if you could neutralize the pain they inflict and maybe even make a friend of them?

Let’s look at a few tips from 51 Ways to Love Your Enemies: How to love others when they are hurting you (Spiritual Self Help) It is free today, and might still be free when you read this.

These are proven strategies that are well worth trying out. I have started using some of them myself.

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Here goes -

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1. To begin, decide to love them the way God does – unconditionally. Everything else follows that path – and it gives you a good feeling that you are doing the right thing.

2. If the person is particularly difficult, at least resolve to always treat them with dignity. It can be hard to resist showing your own hurt feelings. But it preserves your self-respect and shows them you are approachable and safe.

3. Don’t find them guilty in your mind. Absolve them. Remember that old Native American proverb about walking a mile in somebody else’s moccasins? You may never know their full story. But if you realize that pain is likely what is driving them, you know its not entirely their fault.

4. Do something kind for them. This may be as simple as inviting them to join you and friends for lunch, contributing toward their favorite charity drive, complementing their excellence in some skill, verbally acknowledging one of their accomplishments, or any other similar thing.

5. Ask them to teach you how to do something they do well, and be willing to teach them one of your great skills. This allows for a bit of bonding and maybe even a laugh or two.

6. Resist the temptation to say anything negative about them – and don’t stand in agreement with others who do. In such a context, you have but two choices: speak up on their behalf or walk away.

7. Your resolve to show kindness toward them must be wholehearted or not at all – no matter what. Speak only good things over them and wish their family well too.

8. Be honest. This keeps you from becoming a doormat or an enabler to their malfunction. If a moment of openness occurs, it may sometimes be appropriate to mention your reaction directly to the person. And admit if you have been part of the problem. Just do so with compassion, sensitivity, and honor as your guides.

9. Be thankful for them. Remember that each one of us has great value. People are in our lives to help us perfect some attribute a little bit more. Maybe they are our lesson in patience or …..

Anyway, we will benefit from learning it – and so will those around us.

Cheers!

Who Has the Power on Your Unit?

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When you think of who, on your unit, has the most power to affect your day, who comes to mind? Your CNA’s? Yes, probably. They can make you look brilliant or get you into deep kimchi.

Here are some professional secrets learned from Lily. If your CNA’s feel powerless, they will take power silently and look totally innocent about making you fall farther and farther behind.

If they have been given cause, the CNA’s might do whatever they can to put you behind in your work or make you look stupid. If you want to be in power, it pays to empower others first.

The next time your CNA does something you appreciate, tell somebody. You can praise them in public or gossip something terrific about them. Does anything spread faster than gossip on a nursing unit?

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This is fun! Pretend you are upset with your CNA, Deb. Hand on hip and scowl on face, say, Do you know what Deb just did?! I asked her to clean up Ms M (M for messy) in 404 because her daughter is coming from out of town and will be here soon. And poor Ms M spilled breakfast all over herself – again. So, knowing the time pinch, do you know what that CNA did?!

Believe me, if you are doing this with attitude, you will have everybody’s attention, and Deb will also be secretly listening.

Punch line – Deb took time to not just tidy up Ms M – but to fully shower her, make her bed, and totally make her look like an angel before the daughter arrived! What can we all do to show her honor today?

Your comments will lift your CNAs’ spirits, and they will feel good about themselves. They will feel empowered. They will feel important and look at their job as important – so they will do it better.

If nurses are like the spokes in the wheel, CNA’s are like the outer rim. CNA’s are where “the rubber meets the road” in so many ways. They work hard, and they deserve honor and respect.

If your CNA doesn’t seem to deserve any respect, maybe its because they have been torn down for too long  instead of being built up. They can normally be brought back to life with generous doses of honor.

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Simply put yourself in their shoes and do what you would want done by those over you. Including them in conversations goes a long way – as does a smile, helping to make sure they get their breaks, get their lunch, and get help with heavy patients, etc.

Don’t ever feel that it makes you look less important if you talk with those who work under you. The opposite is true. Treating everybody with honor brings out the best in them – and that will make you look good – and your days will go better as well.

For more on this line of thought, check out Danny Silk’s book: The Practice of Honor: Putting Into Daily Life the Culture of Honor

Cheers!

What Nursing Specialty Best Suits Your Personality?

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Are you the one who keeps pressing the elevator button to make it come faster? Or, once inside, do you start talking to all the people because you have a captive audience? Would you actually get off the elevator to let somebody else on?

What would those actions tell about what nursing specialty you should choose?

Are you “thick-skinned” or sensitive? Are you aggressive or passive? There is obviously a place for every personality type in the field of nursing. How can you know which you are?

Are you working Med/Surg but would prefer the Cath Lab? Perhaps your personality type is better suited to a different kind of stress. Maybe taking a personality test would give you some answers.

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There are many personality tests, but the DISC test may be one of the most popular right now. The DISC test asks questions to help you determine what traits are most dominant in your personality. From there, you can determine what career moves might suit you best.

In the world of DISC, D usually stands for dominant, I is for influential, S describes the steady ones, and C’s are conscientious. But there is a lot more to it than just the name describing each trait.

Each trait contains many aspects. For instance – how do you typically process new information? What is your greatest fear? How do you prefer to be led? How do you lead? What is most important to you when completing a task? What influences you most when making decisions?

Are you a ready-aim-fire type of person – or ready-fire-aim (Oops! Sorry!)? Do you enter a person’s home and immediately try to get them to help you re-arrange their awkward furniture placement? (A good example of a D.)  Or would you quietly adjust yourself to their inconvenient arrangement because relationship is more important to you than comfort? (This would be an S.)

When asked to plan a party, do you think out-loud with people until it (sort of) comes together? (That would be a high I.) Or would you be more  likely to privately calculate all of the variables until they were “perfect”? (That would be a C.) C’s have to avoid making mistakes.

Most nurses are high S’s. But what are their other strong attributes? The combination of traits determines the overall personality. Following a career path that flows with who you were born to be helps you be happier in your career and in your life.

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So how does one find out more about these DISC tests? Here are a couple of short, fun YouTube videos that explain DISC very well: https://www.youtube.com/watch?v=yv_RMzmAlOQ or https://www.youtube.com/watch?v=7qrkEO_2hCs .

But nobody explains the DISC like Danny Silk. If you ask YouTube for “DISC Danny Silk” you will get a few from which to choose – and you will laugh yourself silly watching him! Here is the link to a DISC workbook that Danny Silk recommends: The Essential DISC Training Workbook: Companion to the DISC Profile Assessment (Volume 1) .

Cheers!

21 HRT-Free Menopausal Solutions

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Before you waste another penny on Black Kohash, Evening Primrose Oil, and all the rest, try the No White Diet mentioned in the previous post.

Then, to further stabilize your menopause symptoms, consider trying some of the following solutions. Remember – its just a phase. You’ll get through it!

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Drum-roll, please!!!!!!

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1. Stretch to ease tension and stress.

2. Breathe deeply at onset of hot flashes because hot flashes can be associated with an acidic body pH. Exhale for twice as long as the inhale for best results.

3. Exercise regularly because regular exercise releases serotonin and endorphins – plus it improves concentration. Exercise can also reduce vasomotor symptoms and reduce the chance of depression.

4. Maintain a healthy body weight because excess fat contains hormones that make you feel worse – and excess weight can make hot flashes more intense.

5. Avoid too much restaurant food. It tends to promote weight gain.

6. Reduce your stress level, whenever possible, to help ease menopausal mood swing symptoms.

7. Take time to relax. Doing things you enjoy, such as getting out in nature, improves your mood and outlook on life.

8. Try to get sound sleep every night for overall wellness.

9. Get some sun for the vitamin D to help stave off osteoporosis. Adequate sunshine exposure has also been soundly associated with elevated mood – and lack of sunshine with depression.

10. Be extreme & committed until its over because a half-hearted approach will not give you any great benefit.

11. Make a habit of apologizing in advance for sudden, unexpected outbursts. You may preserve more important friendships that way. Seriously!

12. Don’t waste money on OTC herbs because they don’t work if you’re still eating white foods. Use that money for a nice massage instead!

13. Meditate and pray. It brings you closer to your Creator and increases your inner-peace.

14. Sing and dance because its fun and it makes you happy!

15. Stay well-hydrated to make up for fluid loss with hot flashes and sweating. Dehydration can feel exactly like depression.

16. Avoid drinking too much alcohol because it tends to dehydrate you.

17. Stay regular. Everything in your body is going through changes – even your gut. And you know what complications can result from constipation.

18. *Remember – calcium supplements are one of the biggest constipators. So, if you take it, consider taking it with a high-fiber food and extra water!

19. Experiment with expanding food choices on days when you won’t be around too many people – in case the food brings on mood swings.

20. Try pelvic floor yoga exercises and vaginal lubrication to help improve your sex life.

21. Be willing to laugh at yourself and this phase you’re in. It will pass. Might as well take pictures and create some fun memories while you are there!

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Some resources used here focus more on serotonin levels. Others blame yeast overgrowth, low pH levels in the body, excess body fat, sedentary lifestyle, shallow breathing, stress, etc. For further reading: Natural Solutions to Menopause: How to stay healthy before, during and beyond the menopause and What Your Doctor May Not Tell You About(TM): Premenopause: Balance Your Hormones and Your Life from Thirty to Fifty (What Your Doctor May Not Tell You About…(Ebooks))

Cheers!

12 Do’s & 9 Dont’s to Navigate Menopause W/out HRT

Most of us already know how menopausal symptoms and related mood-swings affect us and those around us.  And many of us know somebody personally who has developed cancer soon after beginning HRT.

Of course, we want to regain control of our bodies and behavior. And we want to protect others from our outbursts. But is HRT the best answer? Don’t most of us favor managing our symptoms as naturally as possible?

Who is in favor of navigating menopause WITHOUT HRT? It can be done – and you will feel good (and probably lose weight) in the process. How can this be? you ask.

It is very simple. The answer is: do NOT eat any white foods while you are in menopause. I suggest to you: the No White Diet - and it WORKS!  Adjust according to your own body’s needs (if you are diabetic, on a gluten-free diet, etc.)

Here is a basic list of foods on the DO EAT list:

  1. Organic sprouts & veggies by the plateful
  2. Whole grains or sprouted grains (as in Ezekiel bread)
  3. Brown or wild rice
  4. Sweet potatoes and a wide variety of fresh, organic veggies in season
  5. Raw or only slightly cooked veggies whenever possible
  6. Polyunsaturated fats, such as olive oil
  7. Natural and organic all the way
  8. Hormone-free
  9. Antibiotic-free
  10. Preservative-free
  11. Milk products in moderation
  12. Stevia as a safe sweetener if desired

 

Here is a list of FOODS TO AVOID like the plague:

  1. White flour
  2. White sugar
  3. Large amounts of sweet fruit
  4. White potatoes
  5. White rice
  6. Canned and processed foods
  7. Foods containing hormones and/or antibiotics
  8. Preservatives, nitrites and other chemicals
  9. Excessive caffeine and alcohol

 

Continue these recommendations for at least one year after your last menstrual period, and then decide if you want to continue it as part of your healthy lifestyle.

When I went on this NO WHITE FOOD DIET, I was radical. For example, I found that if I ate even one grape, I was prone to mood swings. So I learned to leave off any sweets at all, including fruit, for that one year. So experiment as you go through.

Although I went on this diet for menopausal symptoms and mood-swing control, I soon noticed, not only those benefits, but also greater alertness and focus – PLUS excess pounds melted off with no effort whatsoever!

What a happy surprise!

In an upcoming post, we will talk about other lifestyle modifications which can also help to navigate and manage menopausal symptoms without HRT.

Plus here are a couple of great books to help you get started on your great journey: No White Diet and No Whites Baking Book: How to Make Baked Goods Without White Flour or White Sugar

Cheers!

 

9 ABC’s to Organize Your M/S Day Shift

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Not having a regular routine will put you behind every time. So if you want to survive in your nursing career, establish a routine. Nurse Lily taught me this. God bless her!

Protect your backside by beginning with the well-lit bedside report. Nothing puts you behind like being surprised by a patient with a bad IV, a urine-soaked diaper/bed, or a patient who is on the floor, unexpectedly unstable,  or dead.

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Here is a plan to shoot for!

1. When you take bedside report, make it count as much as possible. If any patients are going for early procedures, teach them a pre-op tidbit, and do a very quick assessment at that time.  Jot down a few notes to be charted later.

If patients complain about being awakened, teach them that the well-lit bedside report is required – because the hospital requires it, because you have to check their bandage for blood, or whatever is applicable at the time.

2.  Next you’ll check your eMAR’s and grab the 0730 and 0800 meds – plus  your on-call meds for your surgical cases. And, of course, call pharmacy for the missing on-call IVPB’s.

Find out what the blood sugars are so you can give your diabetic meds. If you do not have a good working relationship with your CNA, you might have to waste precious time getting this data yourself – using the poor equipment that all the CNA’s leave behind.

(Watch for my upcoming post on how to maximize the performance of your CNA’s.)

3. Complete your OR checklists for your early cases. Teach a bit about DB&C as the transporter takes them off the unit.

4.  Begin passing the 0900 (and early 1000) meds – start with the patients you have not assessed yet. This time-frame keeps you legal because you saw them at 0700, the CNA saw them at 0800, and now its 0900 – hourly rounds.

5.  Take time to chart your assessments while they are still fresh in your mind – preferably started at the bedside. As you go, answers to patient questions equals patient education.

6.  Schedule your rounds around their med times whenever possible. Remember to address their 4 P’s every visit. It could save you time in the long run. Teach and update patients as you go and chart it.

7.  Always eat lunch. The emptier your stomach feels, “the behinder you will get” on your work. Take lunch.

8. Finish mostly everything, including giving pain meds when applicable, by about an hour before shift change. That leaves you free to finish charting or take care of last-minute patient requests.

9.  Tell patients when shift change will be soon. Whenever possible, tell your patients the name of their awesome oncoming nurse. That sets them up to realize you will be leaving them in another set of good hands soon.

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Interruptions will come, but sticking as closely as possible to a routine will have you feeling more organized and less stressed. You will begin to enjoy your work, coworkers, and your patients more. For more information, this is a great resource: No Time to Teach: The Essence of Patient and Family Education for Health Care Providers

Cheers!

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