Wednesday, August 21, 2013

Nurseables Giveaway: $25 Amazon Giftcard!!


                I have been overwhelmed by the incredible support and great interactions from all you wonderful Nurseables followers out there.  So, in order to thank you, I’m hosting a giveaway contest!  How would you like to be the proud owner of a $25 Amazon shopping spree?  Treat yourself to a cute new pair of scrubs, a new stethoscope or whatever your heart desires (and that Amazon supplies :) ).  All you need to do is complete the entry form and you’ll be entered to win.  Anyone and everyone can enter, so don’t be shy!


How it works:

Just input your information into the rafflecopter form and you’re entered to win the giveaway!
      

But, if you really want to win, here are a few additional ways to increase your chances of taking home the prize:


1. Like Nurseables on Facebook (for those who already like Nurseables, you automatically get the extra points as long as you complete the entry form)

2. Spread the news about why you enjoy Nurseables!  Share Nurseables with your friends on Facebook, Twitter or Google+.  Just share the contest or something about Nurseables, then copy the URL and paste it in the rafflecopter entry form for verification purposes. 

3. Post a joke about nursing or the medical profession.  Feel free to get as corny or silly as you want, we won’t judge.  Just leave a joke in the comment section of this post and fill out the rafflecopter form to enter.

Housekeeping Details:

1. Winner will be chosen at random and notified via email (Make sure to provide a valid e-mail address in the entry form!  If no response is received within 48 hours of notification, the prize will be forfeit and an alternative winner chosen at random)

2. Deadline for all entries is 8/27/2013 12:00AM (PST)

3. All information gathered will be kept private and used only for the purposes of this contest



Best of luck to all contestants and thank you once again for all your support!

This giveaway contest is now over, check back later for another opportunity to win a Nurseables giveaway contest.  Thanks for all your support!

Monday, August 19, 2013

Entering the TwiNurse Zone: What Happens When Nurse Turns Patient?



Do not attempt to adjust your computer screen, we have taken control… You are now traveling through another dimension of healthcare, a dimension not of passing meds and cleaning bed pans, but of the mind; a journey into a bewildering land of your own medical care. Next stop, the TwiNurse Zone! 

Do nurses really make the worst patients?  What happens when we’re on the other side of the bed and receiving rather than giving care?   Well, we can’t speak for everyone because there are so many different personalities and cultures in nursing that it’s unfair to generalize about all nurses; however, from what we have seen, it’s a very different feeling being on the other side… 

Consider Nurse Able, once an able bodied nurse capable of tackling everything that the medical world could throw at her, but now she finds that she herself has become… the patient.  Will her medical training really make her experience better, or will she find that her greatest challenge is not one of the body, but of the mind…  Come with us as we explore some of the common myths about nurses on the other side of the bed through Nurse Able’s journey into the TwiNurse Zone.

Myth #1Knowing everything will make it better

“Does my nursing expertise make everything better? Ha, sometimes it seems like it just makes everything worse!  No sooner do I feel a slight twinge in my mid back than I think I have a kidney infection.  Or, I have a side ache in my RLQ and I start checking for rebound tenderness just to make sure I’m not having an attack of appendicitis.  I even once had a doctor tell me to stop examining myself when I was describing the symptoms I was having!  So, yes it’s nice to understand all the medical jargon and how the medical world works, but sometimes it’s just more nerve wracking knowing all the possible things that could be going wrong.  It’s times like that when I have to remind myself that God’s ultimately in charge and that I need to trust His plan for my life, even if I do end up with a massive kidney infection that leads to multi-organ failure that leads to being stuck on dialysis for the rest of my life. (Exaggerated, I know… but once you’ve seen some of the strange things that people go through, you’ll never be the same).”

Myth #2 - You understand everything that the doctor is saying

“Understand everything?  Not quite… When I’m with a patient as a nurse, I can understand where the doctor is coming from and what they’re trying to explain.  But, for some reason, when it comes to my own body or that of my family, all reason, training and logic seem to fly out the window.  Sometimes, I just go senseless; suddenly I have no idea how to take care of myself or of my family.  

“Half the time, I debate about whether or not to share that I’m a nurse because I really wish they’d just explain everything as if I didn’t know anything!  But, then again, I want the more in depth explanation because it’s my body, so I need to know exactly how everything works.  It’s hard, but at times like that, I’ve realized that I just need to swallow my pride and admit that no, in fact, I don’t know everything there is to know about medicine.  Things are just different on the other side of the bed, especially when you are receiving treatment in an area that is not your specialty.”

Myth #3 - You’re always judging the actions of other healthcare professionals

“Judging?  That’s just a harsh term, but I guess I understand a little where that one came from.  Since I’m a nurse, I know there’s a reason that certain things are done the way they are, and I need to stand up for myself or my family if things are not being done correctly.  I try to keep my mouth shut out of respect and understanding that some people practice differently, but when someone is endangering my health by not being careful or performing a test incorrectly (which might mess up the results that the doctor is looking for…), I speak up. 

“It’s not about wanting to feel superior, but about wanting to make sure things are done right.  If you don’t know how things are supposed to be done, then you don’t know to question.  But I’ve had nurses as patients and they have made me feel incredibly nervous.  Just inserting an IV, I’m praying that I get it right away so that I don’t have to make them feel any worse!  So, yes, in a way I’m watching what is done, but I’m also trying to go about it with an understanding of what it’s like to be the nurse performing the care.”

Myth #4 - Advocating for yourself should be a breeze

“Well, yes and no.  I have cringed about calling the doctor many times regarding issues with my own body because I don’t want to bother them unless it’s absolutely necessary.  As a patient, I really tried not to bother the staff, and I almost even felt guilty to press my call light for help!  After all, I’m one of those who will heplock my own IV or apply pressure to my own arterial bleed if you give me half a chance!  However, it does help to have a medical background because you have a better understanding of the seriousness of different concerns and when it really is important to stand up for yourself or your family member.”


Nurse Able, an able bodied nurse who experienced the disabling effects disease can have on the nursing mindset.  Nurse Able, a wise professional who took the experience of being a patient to look closely at the life on the other side of the bed in the TwiNurse Zone.


Medical Morals to Remember –

·         When teaching a nurse, perhaps start by asking them what they know first instead of assuming that they understand everything that’s going on with them.  Then, adjust your teaching plan from there.
·         When you’re the patient, treat your nurses with understanding, but don’t be afraid to bother them if you need help or have a question about the treatment you’re receiving.
·         Consider having someone else at your side to help you advocate for yourself and to ask the questions that need to be asked.
·         Give 100% of your patience, kindness and passion to everyone in your care, whether nurse or not, because you never know when it will be you or your family member on the other side of the bed.

  
Have you ever been there?  Do nurses really make the worst patients?  What morals have you learned from your experiences either taking care of nurses or being the patient?

Friday, August 16, 2013

If You Give a Cancer Cell a Cookie, It's Going To Want a Glass of Blood...



“Ok, listen up people!  We’ve only got 9 months to get you guys into tip top shape, and then… it’s game time.  You may just be young embryonic cells now, but when I get through with you, you’ll be more than ready to take on the game of life,” yelled the coach, staring down firmly at each undifferentiated cell in the little forming fetus.  “You may be able to nurse off your mommy’s umbilical cord right now, but that’s not going to happen forever.  Pretty soon you’re going to be out there on your own and if you don’t follow what I’m saying, you’re going to be in a world of trouble.  You’re going to need the information I’m giving you, so listen up!  The most important thing you have to remember is to never, ever, under any circumstances… give a cancer cell a cookie!”

The little cells had been listening as intently as they could, but their immature attention spans couldn’t hold on any longer after a long day of learning.  Soon, they were all giggling uncontrollable at the thought of cookies causing their coach to look so stern!  “What are you laughing at?  There’s no laughing in cell differentiation class!” scolded their coach.  Brought abruptly back to attention, they looked intently once again at their teachers face.  “That’s better. Now, stick with me you younglings and we’ll have you in tip top shape before anyone can say ‘Rockabye Baby on the Treetop.’  Any questions?”

One tentative hand rose up to ask the question they’d all been wondering.  “Umm coach?  I though Instructor Ribosome said that nutrient cookies are good for us.  They’re full of oxygen, glucose and all the wonderful nutrients that help us grow!  Wouldn’t that help those poor, deformed cancer cells you were showing us pictures of earlier?” 

“Ah…. You’d think that, but there’s a very important reason why we say to never under any circumstances feed a cancer cell… Ok, I can see that’s not going to fly with you guys.  Lesson time!”  All the kids quickly sat up straight and focused as attentively as their young brains would let them. 

“If you give a cell a cookie, no big, it will just process it into energy that’ll help the whole body to function properly.  But when you give a cancer cell a cookie… watch out because it won’t just end there, it never just ends there…  First though, can anyone tell me what we talked about yesterday?  Does anyone know how a cancer cell becomes a cancer cell in the first place?  Yes, Milly Myocyte?”

“A cell turns into a cancer cell when something messes with its information manual, its DNA code.”

“That’s right Milly.  You’ve been given a set of specific instructions about how to act, when to grow, when to stop growing, what to make and things like that.  But, when something like a free radical gets into that manual, it changes those instructions.  Then, after enough mutations happen to that manual, poor little, nice cells turn into uncontrollable monsters just like that!  Now, does anyone remember what you can do to try and prevent anything from happening to your precious manuals?”

“Eat a lot of antioxidants!”

“Precisely, so you were paying attention!”

“Yes teacher, but I still don’t understand why we can’t give cancer cells cookies.  Maybe if it’s some supercharged nutrients, it will help them get back on track!”

“No, no youngling… that won’t work at all because it won’t end there!  They’ll just keep going and going and...  You see, it’s like this… 

If you give a cancer cell a cookie, it’s going to ask for a glass of blood.

When you give him that little bit of oxygen and nutrients, he’ll probably ask you for a space to grow.

When you give him space to grow, then he’ll divide and make a friend.  When he’s finished growing a friend, then they’ll both ask for more food. 

If they get some more nutrients, they’ll make it a party and rapidly divide to create more friends (oncogenesis). 

Pretty soon, they won’t be enough room for them all, so then they’ll want to expand into neighboring homes.  At that point, you might try to tell them to stop dividing because they’re taking up all the room, but they’ll just turn a deaf ear to your signals.

By that point, they’re going to need a boatload of oxygen, glucose, hormones and nutrients to survive, so they’re going to want some more blood.  But it won’t stop there.  When I say blood, I mean they’re going to want their own dedicated blood supply, so they’re going to want to grow their own blood vessels (angiogenesis).

Then, inevitably, there’s going to be some that get tired of hanging out with the original site crowd and want to start a party somewhere else, so they break away from their current party and spread through the blood or lymphatic systems to a new location (metastasis).  Once they’re happily at home in another part of the body, then they’ll just start the process all over again. 

Then soon, all of your resources will go to feeding those abnormal cells and there won’t be any energy left to spare on things like maintaining homeostasis!”
“Wow…” one of the cells uttered in astonishment.  “And that all just started with a simple, yummy cookie?”

“That’s right kids! So please, whatever you do, don’t give cancer cells any nutrient cookies, or else, before you know it, they’re going to want a glass of blood!”



This tale has been simplified for the sake of giving a basic understanding of the workings behind cancer.  If you’re interested, I highly recommend checking out some of the additional resources for more in-depth information.  And if you find any other great resources, let me know so it can be included in the additional resources for others to find!

Medical Morales to Remember:

  • Carcinogen – something that damages a cell and makes it more likely to become cancerous
  • Mutation – changes in a cell’s DNA
  • Cancer cells – develop from multiple mutations occurring either during reproduction or from carcinogens.  Precancerous cells often are destroyed through apoptosis or by the immune system, so it typically takes a long time before a true cancerous cell escapes the body’s natural defenses and starts to multiply.
    • Characteristics (From Cancer Research UK):
      • Don’t stop reproducing themselves - Oncogenes
      • Have Tumor Suppressor Genes turned off – genes which tell the cell when to stop multiplying and to destroy itself (apoptosis) if damaged
      • Don’t listen to signals from other cells
      • Don’t stick together (metastasis – travel to other parts of the body)
      • Don’t specialize, but stay immature
  • Angiogenesis – creation of a new blood vessel


Additional Resources:


Cancer Support and Blogs:


Do you have anything to add?  Was this story helpful? How have you explained or remembered the workings of cancer in the past?

Wednesday, August 14, 2013

You Tell The Tale: Pain Med Grievance


Pain is whatever the patient says it is, but how far is too far and how much is too much?  Would you give undiluted morphine and push it fast because your patient insisted, or is there more to the story?  Should the nurse be more “by the book” or administer the medication exactly as her veteran patient requested?  

How it works:

Nurseables will start with a fictional account of a difficult nursing situation to get the discussion going.  Then, you write a comment about how you think the tale should end.  Anyone is welcome to write in, even if you don’t have a nursing background.  So write a comment, tell us your thoughts, play the role of the granddaughter, the patient, management, the nurse or a fellow coworker.  Get creative, have fun and let’s learn from each other!

Just a couple of rules to keep in mind:

1. Be cognizant of HIPPA, do not give any identifying information away in your discussion
2. Be kind and courteous in your responses


(Disclaimer: This is an entirely fictitious situation and any similarity to the characters or patients is completely coincidental.)


As always, looking forward to hearing your thoughts, comments, and creativity!
______________________________________________________________________

          “Alrighty then, those labs are looking good, so I shouldn’t have a problem giving the Lasix to Mr. Parker as long as his blood pressure…”  

Ding, ding, ding! rang out a call light down the hall. Disturbed out of her thoughts, Nurse Newbie looked up to see who was asking for help.  Sure enough, the call was coming from exactly where she had expected.  “Ah, right on time.  I swear, she’s gotta have an alarm set or something because that woman’s like clockwork!” she whispered to herself.  Caught up as she was in the beginning of the shift hustle, the interruption wasn't exactly welcome but she was there to take the best possible care she could of the patients in her charge.  Quickly saving her work, she made her way down to check on the situation.

“Yes Mrs. Jenkins, how can I help you?”  she inquired as she walked into the room, visually checking around to make sure everything was in order.

“Oh hello there Nurse Newbie, can I have my pain medication now?  It’s due in 5 minutes so I want to make sure you’re aware that I want it,” Mrs. Jenkins kindly requested.  In report, Nurse Newbie had understood that the sweet woman in front of her came in frequently with COPD exacerbation, but that she had terrible back pain.  She’d been told that Mrs. Jenkins always wanted her pain medication on the dot or else she threw a horrible fit, but…she didn't seem like that kind of person.  Maybe people just didn’t understand the pain she was going through or she’d just learned she had to be firm in order to get any relief…  Either way, she’d been told in nursing school that pain was whatever the patient said it was and that was the advice she’d go with because going with the flow just made life easier for both of them.

“Absolutely, I’ll go prepare it right now and be back in a jiffy.”  After a few probing questions to learn the extent of the pain and a quick look at the heplocked IV in Mrs. Jenkins’s left hand, she was off to prepare the dose. 

Now, being a relatively nurse on the floor, Nurse Newbie wanted to make extra sure that she didn't put her patients in harm’s way or put her hard-earned RN license on the line, so she double checked trusty Drug Guide from nursing school and prepared the dose accordingly.

Somehow skating by without interruption, Nurse Newbie promptly returned back to Mrs. Jenkins’s side with the 4mg of morphine the doctor had ordered, diluted to the concentration her drug book had indicated.  However, when she returned, Mrs. Jenkins started to dictate how things should be done for her to feel the full effect of the medication.  Unfortunately, all that she said went right in the face of all that Nurse Newbie had been taught and read in her drug book!  Push it fast.  Keep it undiluted.  Follow it quickly by a chaser of two full syringes of normal saline flushes…. and whatever you do, don’t you dare check my blood pressure first, I've been bothered enough as it is!

“Umm… Mrs. Jenkins, I hate to disappoint you, but I don’t feel comfortable with that because that’s not going to be safe for you…” Nurse Newbie tentatively replied.


“Oh, you don’t want to take care of me?!  Fine!! CHARGE NURSE!!  Get the doctor in here now to write an order about how I have to have my pain medication!!!”


What do you think?  Do you have any advice for Nurse Newbie?  What would you do?  Have you ever been a patient or family member in this kind of situation?  Is there another side to the story?  Leave your opinion or finish the tale in the comments below!

Sunday, August 11, 2013

Pictures Worth a Thousand Words

Since it's so much fun to share, here are some clever, funny and inspirational images that have stood out lately.  Which one's your favorite?









  




Life Goes On...



And just to keep things interesting, can you caption this photo?