I had an amazing experience on the floor this week.  It was the first week for the students and we passed many medications, performed dressing changes, bed changes, and bathes.  The students performed so well and the staff nurses were welcoming, nurturing, and helpful to me.  When we have more than five or six students on the floor it makes it almost impossible to give each student a positive experience that is filled with learning.  I want to give a shout out to the nurses on 2SE at Clark Memorial Hospital in Jeffersonville, Indiana.  Cindy, Carol, Diane, and Del.  Thank you for being positive role models, mentors, and advocates for the student nurses!  Many nurses could learn a few a things from you! 

What are YOU doing when you witness HV among your colleagues?

 

        Is the manager or the director of your unit degrading to the staff nurses?  Have you witnessed maltreatment of a colleague and not done anything about it?  If we stand by and witness HV in nursing and do nothing about it, we are as guilty as the perpetrator.   What type of care do you think the patient who the targeted nurse was caring for, received after the verbal abuse?   HV in nursing is the same type of behavior as bullying.  We do not accept or encourage bullying so why are allowing HV in nursing to go on and on and on?

       Be an advocate for your colleagues and for the patients you serve.   If this type of behavior is occurring in the facility you work at, follow the chain of command, and help stop this behavior among nurses.  Make sure you have all of the facts.  Document the date, time, who was present, exactly what was said, and how it made you feel.  We must rally together to stop this type of behavior among nurses.   When we have zero tolerance for HV in nursing, we will have better outcomes for the nursing staff and the patient's served. This is a win - win colleagues! 

      Have you been in this position?  What are your thoughts?

 

Banding together to "grow a nurse"

Nurses are taught by nurses.  Education is provided in the classroom and at a facility taking care of patients under the watchful eye of seasoned nursing faculty.  All nurses have been taught in this manner so how could nurses ever forget they were once a student?  While some nurses are welcoming and share their wealth of knowledge with nursing students, others…not so much…we hear “stay out of my way” or the student is completely ignored by the seasoned nurse.  Sometimes they make life very difficult for the nursing student.  Learning and comprehension do not occur when a student is stressed.  Students learn when their mentor is calm, welcomes questions, allows time for the student to think of the answer to hopefully have positive patient outcomes and for the student to have that “ahha moment”!

Why oh why would a nurse act like the student is not in their presence?  Why would they make the student feel like they were in the way?  When I facilitate clinical, I go in to the patient’s room and introduce myself, and ask, “Is it okay if we have a student come in and help take care of you today?”  (I have been facilitating clinical for seven years and have only had one patient decline a student.) When the patient advises it is okay, I will throw in, “Are you okay with a male student?” (Again, I have only had one tell me no males, so we assigned a female student.)

If I were the nurse in labor and  delivery, I would do exactly what a physician does when they have an intern with them…they bring them in.  They do not ask permission because this is how physicians AND nurses learn.  The student is observing only.  Many times we have heard the seasoned nurse walk into the patient’s room and say, “We have students today and you do not want a student do you?”  Presentation is everything!  Even if a student observing would have made no difference to the patient, it surely will after a question like that!  The students have advised many times during the clinical day, when they are paired up with a nurse, they are ignored.  Attention all directors, managers, and staff nurses….at one time, you were a student once, we must band together to “grow a nurse” and stop this form of horizontal violence in nursing.

What are your thoughts and comments?

Family Smooth Over!

We have all been through this:  Patient is fine, no complaints, pain is under control, and all is well.  The family arrives and suddenly everything is wrong!   How can a nurse handle this without causing more stress to the patient, the family, the rest of the staff, and other patients on the floor?  Learn to smile (ALWAYS), gently touch their hand or arm and say, "You know what, you may be right, but, what can I do FOR YOU, RIGHT now that would make things better?"  The family member is so shocked that you said they might be right.  In their mind they are thinking, "She/he said I might be right, she/he wants to do something for me".  It may as simple as a cup of coffee or a warm blanket.  Try it, it is hard to be mad at anyone that has a smile on their face.  Does this work EVERY time?  Of course not, but more times than not, it works.  Remember that you do get more with honey than you get with vinegar and it only takes one person to make a difference and that person is you!

Tip to start the day off right

When we get off the elevator in the morning and hear "Run, it has been a nightmare", this starts the day in negative manner.  Negativity breeds like wildfire.  Learn to smile and say, "Everyone must be taken care of, give me report so you can get out of here!"  Breath, get report, go on walking rounds, and smile at your patients.  Will make a difference in the outcome of their day and yours!  Try it, I would never steer you wrong!

"What the horrors of war are, no one can imagine. They are not wounds and blood and fever, spotted and low, or dysentery, chronic and acute, cold and heat and famine. They are intoxication, drunken brutality, demoralization and disorder on the part of the inferior... jealousies, meanness, indifference, selfish brutality on the part of the superior."  (Florence Nightingale, Mother of Nursing)

What does this quote say to you?  My perception is there has been a war within the culture of nursing for many years. Any thoughts?

 

Recently spoke with an individual who went to a very plush rehab center.  The nurses were not friendly, did not have knowledge of the medications they were administering, told the patient to "just take them, the doctor ordered it, I don't know what it is for."  The individual was intimidated and feared retaliation if she complained of the care she was receiving.  What type of patient outcome do you think this was?  The individual did not feel good about this experience and anyone she relays her experience to will not go to this facility.

Nursing 101 and for the rest of your life:

• ALWAYS know what medication you are administering to your patient, along with the side effects why the patient is taking the medication, and how it will benefit them, both short and long term.
•  If you do not know the answer, find it.  You may have to excuse yourself and find the answer or you can simply look the info up on the computer you should ALWAYS have with you when administering the medication since we do have an electronic medical record (EMAR) in the majority of facilities now.  If your facility has not transitioned to an EMAR yet and is still using a paper MAR, know the info before you enter the room.
• NEVER intimidate the client, this does not promote positive patient outcomes.
• Nursing is life long learning, we never know everything and do have to look information up or ask questions of our colleagues.  The minute a nurse tells me she/he knows everything, I am afraid of  them.  They are a danger to the patient served and their colleagues.
• Smile....you may be the only bit of sunshine the patient sees all day.  One person can make a difference and that one person is you!