I have wanted to be a nurse since high school and I have never regretted going into nursing school or have wanted to do anything else. So, when people ask me what I think about nursing I have mostly positive things to say. I tell them the opportunity to work 3 days a week is an amazing schedule. There is still time to have a life and travel without being locked down working 5 days a week. The money is good and helping people for a career is rewarding. I meet a lot of interesting people that like to tell their life stories. Some are interesting and some make you wonder what the heck they are talking about. Some people don’t like to converse very much or are unable to speak during some point in their hospital stay, and others won’t let  you leave the room. At that point sometimes you have to say, “i’ll be right back”, just so you can go see your other patients. I do realize that I am there for the patient so I usually try and make them feel comfortable by asking them questions about themselves. I think it’s important to make that connection with people when at that moment they just need someone to talk to and make them feel comforted. When I was in the hospital for 4 days with a pelvic fracture from a car accident, I remember one nurse having an impact on me, which was only one of the days I was there.  Her name was Jan and I remember that because she is the only nurse that talked to me and bathed me. She washed my legs, which I could not bend down to wash and she asked me questions while she was doing her assessment. I liked her at that moment and thought she was a great nurse for taking the time to talk to me, even though I know she was busy and I didn’t need a lot of care. My perception of the other nurses I had was that they thought I was an otherwise healthy young girl that didn’t need any nursing care and the aid could tend to all my needs.  I thought this because I never saw any of the other nurses. Maybe I never saw them because they were having a potluck in the lounge… Come on nurses, you know what I’m talking about! I was in nursing school at the time of my hospitalization, so I was observing the nurse’s behaviors and it didn’t bother me that they didn’t come check on me, but I was hoping to learn something from them. As a nursing student, I worked with this nurse at the hospital I was a patient in and due to her harsh, unfriendly behavior I was glad she was not my nurse. She was scary and I know she hated nursing students. I remember being upset one time because a patient was cussing at me and that was the first time I had experienced that. So, she walks by with her attitude and says, “welcome to nursing” and walks away. I’m not sure how she treated her patients, but I knew I did not want to have an attitude like her and potentially scare my patients. So, in my nursing career I want to be that nurse that the patients like and remember because I took the time to provide great care and go beyond the daily routine of assessments and passing medication.

This post on Life with Lydia made me reconsider my plan to wean G by May.  I’m not sure I want to miss out on his thoughts on breastfeeding.  I mean, he lets me know he likes it, of course, but it would be so fun to share the experience with him when he can express himself a little better.

Then again, 90% of the time I feel like I want to be done.  And I want to be able to go away for a few days when my parents are visiting.  Oh man.  Decisions, decisions…

GENTIAN VIOLET

Thrush.  The bane of my existence.  For three months Miss S and I did battle with it using Nystatin, until one day the Public Health Nurse suggested Gentian Violet.

Gentian Violet (1% solution) is purple… so VERY purple.  It temporarily stains skin, which is wonderful (not) when painting it into a squirming 6-month-old’s mouth.  Never mind the fact your own chest turns purple in the process.  Very sexy.

Miss S looked like a punk rocker, with her purple lips and naturally occurring mohawk.  Naturally I took pictures, but it still made me cringe every time I dipped the Q-Tip into the bottle.  Especially since the warning label states:  May irritate eyes, skin and mucous membranes.  May be harmful if swallowed.

Along with the Gentian Violet, I disinfected all of the toys Miss S had come into contact with and ran my bras through a daily vinegar hot water cleanse.  It felt like a mountain of work at first, but four days later we were thrush free.  Yes, that’s right: FOUR DAYS as opposed to the THREE MONTHS we’d been battling it previous – hooray, but arg.

PEDIATRIC CHIROPRACTOR

Miss S howls when we put her in her carseat.  She wails when we put her in jackets and shirts.  Normal baby behaviour?  Probably.  But just to make sure she couldn’t turn around and write a “Mommy Dearest” novel about how her parents ignored her pain, I took her to a pediatric chiropractor for a check-up.

Holy cow.  Let’s just say this was potentially the best $40.00 I’d spend in a looong while.

The chiropractor was awesome.  So quietly attentive to Miss S.  Her adjustments were subtle.  It just looked like she was walking her fingers under Miss S, and sometimes rocking her.  For her part, Miss S lay on her back, on a blanket, and played with stuffed farm animals.  (I think Miss S was happy to have the toys all to herself.)

Even though the chiropractor found nothing wrong with her shoulders, she made some other adjustments to help with gas (the bane of Miss S’s existence).  Didn’t even know gas was in the chiropractic realm, but it makes sense, and I’m grateful.

It’s only been one treatment, and yes, with babies you can never 100% guarantee anything.  BUT, here are the changes I’ve witnessed in the last 12 hours:

1. Appetite.  Miss S is hungry.
2. Burping and Farting.  She is no longer holding onto them for hours on end.  She eats, she burps.  Badda-Bing Badda-Boom.
3. Lying on her right side to nurse.  She actually is doing this without fussing.
4. Sleeping.  Here it is 2.5 hours after I placed her in her crib and she’s still asleep.  Has not woken once on account of gas pains (as has been her norm for the last 6.75 months of her life).

Clearly the night is still young.  I have not exhaled and tucked myself into bed.  But for now, this moment, my baby is peacefully slumbering.

It was almost 2 months or 60 days to be exact of stressful and anxiety-provoking experiences before the Professional Regulation Commission (PRC) finally decided to release the much awaited exam result of this land – The November 29 and 30, 2009 Nurses Licensure Examination result. About 37,527 board takers or 39.7% survived the nerve-wrecking NLE. I jolted in surprise & couldn’t stop my tears running on my cheeks as i saw my name in the list of NLE passers on the Inquirer website last January 30, 2010. I couldn’t believed myself I belong to these survivors and now here i am – a full-pledge Philippine Registered Nurse. Lucky Me! hehehe!

This morning, about 1,000 new nurses from Davao City and nearby regions gathered at the CAP auditorium for an oathtaking ceremony. Due to a large number of oathtakers, PRC decided to split the populations into morning and afternoon sessions. Parents & spectators were not allowed to enter the hall in this solemn ceremony, of course PRC would not want all of us to fall down during the event due to our huge numbers.

The oathtaking was attended by Hon. Marco Antonio Sto. Tomas, one of the member of the Board of Nursing.

It is.  It keeps getting intertwined in my flip flops and I just step all over the big pink bastard.  Impossible.

Today was splendiferous.  Not the events of my day, but the weather.  God bless living in the south.  I kept having these zen blissful moments the entire day long.  And no, I was not high.  Or having a flashback.  I just sat on my deck, and was completely peaceful, and happy, just looking at the sky.

The events of the day were pretty shitty actually.  I couldn’t file my weekly unemployment because my benefit year is up.  I tried calling those hard working state employees, but their line was so clogged the message just said my call could not be completed at this time.  When?  When can it be completed?  This is bad news.  This is very bad news.  I may actually have to get a job.  Fuck.  But the weather was so glorious, I just felt like maybe, everything will be okay.

I could be a greeter at Walmart.  Lord knows I spend most of my unemployment checks there.  Or I could stock grocery store shelves, or sell cigarettes to non-minors at the gas station.  All of these things make me want to die a little.  I want to be a nurse, but that requires a lot of school I would have to coordinate making money, with finding affordable child care.  Fuck.  Again.

So there is the ever-unpopular idea of being a surrogate.  Birth someone else’s baby.  I am drug and disease free.  My womb is not doing anything else.  It might as well bear life for someone who otherwise can’t.  Lord knows I am not dating anyone.  Ever, at all.  So what difference does it make if I’m pregnant while picking up diapers at Walmart?  None at all.  Then I can blog about my nipples, and throwing up, and dr. appts.  Jesus.  This is my life.

I am a good mommy chick.  I take care of my baby chicks.  And if I have to sell peach-flavored-blunts to disaffected youths, or have someone else’s baby to make sure my babies have food, and a place to sleep, I will do it.

Queue the Gone With the Wind exit music………….

1st half.  Insert disc two.

Speaking of movies… I am watching “Running with scissors” right now, in my snuggie.  The book was fantastic.  And there are a lot of famous actors in this flick.  Maybe it will be good.

Doctor’s Day is Tuesday, March 30 and Nurses Week kicks off on May 6^th this year.

There is still time to order gifts for doctors…ask me how!

1. Search PubMed using the following search terms:  Diabetes Mellitus, Type 1 AND nursing
2. Search Google Scholar using the following:    nursing “Diabetes Mellitus, Type 1″

This is an old article, but I want to publish it here just to show that this problem has been going on for quite some time and still is no further along towards any resolution.  I am sure that if the hospital administrators had to work the floors as nurses, there would be a fast action, but since that will never happen I expect little to no headway to be made along the lines of mandated nurse-to-patient ratios.

Nurses will just continue to get frustrated and burned out and drop out of nursing altogether and we will continue to hear about the “horrible” nursing shortage.  If the nurses who currently hold RN licenses were to all come back to the profession right now due to better staffing and nurse to patient ratios, would we even still have a “nursing shortage”?

This article just lets you know that we have been fighting this battle for a long, long time.

_______________________________________________________________________________________

The data is in. The fewer patients assigned to nurses, the better the patient outcomes. So why does Nevada, particularly Southern Nevada, have high nurse-to-patient ratios?

Some argue that it’s all about the money. After all, it is logical that fewer nurses caring for more patients could yield higher revenue for hospitals. It can also ensure a cycle of repeat business by way of “frequent flyers.” For example, a male patient is hospitalized to get a knee replacement. Because his nurse has ten other patients, the nurse is unable to adequately protect him from acquiring an infection. Thus, the patient must stay an extra few days for antibiotic therapy. He is rushed out of the hospital because of the HMO factor and receives little to no discharge teaching because the nurse is putting out fires for the other nine patients. The patient returns a week later with a bowel obstruction because he didn’t understand that the pain killers he took home could cause constipation. So much agony could have been avoided if a nurse had had the time to adequately address his needs during his first admission.

So are high nurse-to-patient ratios about the money? Or is it unavoidable because of the highly publicized nursing shortage? Let’s get right down to the stats.

The American Hospital Association (AHA) reported in April 2006 a national registered nurse deficit of 118,000 RNs “to fill vacant positions nationwide.” (1) In the December 2003 issue of Health Affairs, distinguished nurse researcher, Peter Buerhaus, published interesting statistics supporting our nation’s increased dependence on “foreign born” nurses. (2) However, this same data appeared to indicate a surplus of 600,000 registered nurses in the U.S., not working as nurses. A surplus of 600,000 nurses could well eliminate the AHA’s reported 118,000 deficit.

When questioned by email about this surplus, Buerhaus responded, “There are roughly 500,000 individuals who are licensed to practice as an RN in the U.S. today, but who are not currently working.” He then speculated that perhaps many of these nurses are retired, too old to work, independently wealthy, or have chosen to stay home with children. But nurses working in the hospital trenches of Nevada, where some of the highest ratios in the country exist, need not speculate why Nevada has the worst shortage of nurses in the country. To them the reason is: burnout.

Another argument challenging ratio enforcement is the hypothesis that ratios would be impossible to meet and would therefore cause hospitals to shut down. But according to Deborah Burger, President of the California Nurses Association, where mandatory ratios are in full force, “After many dire predictions about closing hospitals and wards by the California Hospital Association, there were in fact NO hospital closures let alone unit closures in California due to the ratios law. It is not just my wishful thinking but actual facts reported to the Department of Health Services.”

Did California have an abundance of nurses to support mandated ratios? Before ratios were imposed, California ranked last in numbers of nurses per capita and Nevada ranked second to last. Today, California has increased its numbers of nurses per capita, now leaving Nevada in last place.

The California Nurses Association has embraced nurses is Texas and other States to help them achieve mandated ratios as well. In a report by The Texas Observer, “Even Schwarzenegger’s office has acknowledged that California’s law has produced some benefits. For one thing, it’s lured thousands of nurses back to work, easing that state’s shortage.” (3)

How did the California Nurses Association manage to beat the odds and attain ratio legislation? Ms. Burger reports, “Since we left the ANA [American Nurses Association], we have accomplished more in the last 12 years than in the previous 50 years with ANA. Since then we have put forward safe staffing legislation (ratios and whistle blower protections) in Illinois, Maine and Texas. In all states, ANA has opposed the bill, but we are moving forward because nurses (just ask any traveler who has worked in California recently) know this will make a difference.”

California has set the standard for hospital nursing care. There, medical-surgical nurses are assigned a maximum of five patients, while here in Nevada it is customary for nurses to have twice as many.

So the next time someone offers statistics supporting a particular view, recall what Mark Twain said, “There are three kinds of lies: lies, damned lies, and statistics.”

(1) http://www.aacn.nche.edu/Media/FactSheets/NursingShortage.htm

(2) http://content.healthaffairs.org/cgi/content/abstract/22/6/191

(3) http://www.texasobserver.org/article.php?aid=2495

Lillian Gonzalez, BSN, RN

Las Vegas Agency Nurse

NurseLily@AnAmericanRN.com

Here’s the link to the original article

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