Tuesday, September 11, 2018

Never Forget

photo ©Kathy Quan
No words needed. #NEVER FORGET!

Friday, September 7, 2018

That Certain Patient

Dianne Cabelus-Braley

I think it’s safe to assume many of us as nurses at one point or another have had that certain patient that we somewhere along the way became a little attached to,  maybe caring about a wee bit more than the rest.  I realize as a nurse this probably is politically incorrect to say but this happens.  We are human.  But if we are performing our job correctly it is that that we care more about not provide better care for certain patients from time to time.  In other words…  We kinda just like them better.  That being said we as nurses take an oath and in that we are to provide the best care that we can while remaining neutral, empathetic and objective but this does not mean we are lack emotion.  As a nurse that is the main component in our job, to care which is based on emotion.  With some certain patients we just find ourselves becoming a bit more invested.  The reasons this happens, who knows?   

Sometimes we relate to the person and find commonalities between us.  Other times they may remind us of someone we know or maybe we just get along well.  I think that we have all found with some certain patients we invest a little extra time and this can make it that much harder to leave them and even more difficult when they leave us.  I know that for me the patients that I have bonded with the most are the stubborn difficult ones who have a quick wit but can make you crazy.  My husband would say that type of person is very familiar to him.  I have found these are my most challenging patients but the ones that I get the most satisfaction in helping when they finally allow me to do that.  A nurse patient relationship is an intimate and unique one.  It’s really no wonder we get attached at times.  In this profession there are many highs and just as many lows and we occasionally find ourselves on an emotional roller coaster.  

So how to deal...

Rule number one is you need to balance empathy with objectivity and this can be difficult, especially for a new nurse.  It can be a slippery slope when you are to care for someone but at the same time not become emotionally invested.  While yes, with some patients being objective and neutral will be easy to do.  Others you may find it hard to balance and that’s normal. 

How to balance…

Keep it professional and keep the focus on the patient.  You don’t need to disclose your personal life to with your patient and it is actually unprofessional if you do.  You can have conversations but keep things general and non-specific about yourself.  This is not only in your best interest but in the best interest of the patient.  The focus should always be on them.

Start off on the right foot…

Getting to close can cloud judgement so start off with each patient the same.  Learn to keep a compassionate distance to protect yourself and your patients.  This can start with setting clear expectations and boundaries with your patient and their families in the beginning as to the role you will play in providing care.  I have found being a homecare nurse for years this is of vital importance.  Start off right. 

Take personal inventory…

Reflect on how your feeling throughout the time you are spending with the patient.  Are you divulging to much personal information?  Are you becoming emotionally invested?  Is the care you are providing in your patients best therapeutic interest.  If you feel that the boundaries have become blurry.  Talk to a co-worker or manager about switching assignments or maybe  not seeing this patient for awhile.  Protect yourself and protect your patients. 

Dianne Cabelus-Braley is a registered nurse currently working as a clinical documentation specialist and nurse blogger.  She has a had a lengthy and colorful career in nursing and also holds specialized credentials in both nutrition and aesthetics.  Dianne resides on the north shore of Massachusetts and is married with two human children and is also mom to two dogs and five chickens. You can check out Dianne's blog at www.nursingtheneighborhood.com

Thanks Diane for this great post!

Thursday, August 30, 2018

Best New Grad Preceptor

Becoming a preceptor is an honor for many nurses. Yes, it’s going to be more work and you probably won’t get out on time while you’re doing it, but it can be quite rewarding in many ways. Like any new challenge, you need to prepare, and the better you prepare, the easier and more successful the outcome.  

Onboarding a new nurse whether a new grad or even a seasoned nurse, needs to be a positive experience to make for a well-prepared, happy new employee. You need to help her/him learn the ropes and the culture of your facility and feel welcomed into the community with a strong understanding of the expectations and responsibilities for quality evidence-based patient care.

Take note that not all situations work out perfectly, and many times no one to blame; it just wasn’t a good match. Keep your manager informed throughout and be honest and subjective. Read more....

Monday, August 27, 2018

Flexi Clip Giveaway Winners!

Thanks again Laurie Young for your Lilla Rose Flexi Clip Giveaway.

The 2 winners are Carol Chiocchi and Josette Stegmair. Congrats! Laurie will be in touch with each of you. Enjoy your Flexi Clip! Thanks for all the great entries.

If you didn't win, I hope you'll keep Laurie in mind and support her business. These are really nice products.

Sunday, August 19, 2018

Flexi Clip Give Away

Hello!  My name is Laurie Young.  I have close friends and family members in the nursing field and have always admired their patience, gentleness, and genuine hearts.  I know you are under-acknowledged and under-appreciated which is why I am so excited that you are discovering the world of Lilla Rose and even more that I get to give away TWO of our amazing Flexi Clips to the lucky winners (one to each winner)!  
The Flexi Clip
The Flexi Clip is the product that I fell in love with several years ago and caused me to become a consultant with Lilla Rose. It is a patented, one-piece, flexible hair clip that works in all types of hair, from baby-fine to extra-long and thick. It comes in 7 sizes, and enables you to do a variety of simple hairstyles, from a half-up to a full french twist, in less than 30 seconds!  It is perfect for anyone who needs their hair to stay put, out of the way, all day long…my nursing friends have fallen in love.

For our complete line of beautiful, versatile, & durable hair accessories, visit my website or my Facebook page.  Both sites have videos showing a variety of 30 second hairstyles.

This double giveaway includes 2 winners, one flexi clip each!
To enter, complete my online form here:
Entries will be accepted until midnight (EST) Sunday night, August 26, and the winners will be chosen on Monday morning, August 27.  Winners will be chosen at random. 

Winners will be announced here on The Nursing Site Blog, as well as my Facebook page. The winners will be announced on the blog Monday evening, August 27. Good luck and have a wonderful day!

Thanks Laurie!

Thursday, August 16, 2018

Nurse CEO Success Summit in Los Angeles

I'm excited to be a speaker at the Nurse CEO Success Summit in Los Angeles on September 29, 2018!  The event will bring business experts together to share how they have hacked technology to create a better business, process, environment, or world! All entrepreneurs are welcome to come! I hope to see you there. http://www.nurseceo.co/successsummit

#nurseceosummit @TheNurseCEO @the_nurseceo


Tuesday, August 14, 2018

Life-Work Balance and Self Care

In keeping with the self-care theme this week, I would like to bring your attention to a terrific Work/Life Balance Guide I received a link to a few days ago. From GroomandStyle.com this guide to decreasing stress is just what nurses need! There's tons of ideas to work on and ways to gain control of your life and the situations that seems to drive you up the wall! Check them out and see if you can find a path to clearing out some of the major stress from your life.

It's not rocket science and for nurses it's not new. It's about prioritizing, delegating and reviewing the success or failure. But it provides some very realistic ideas and best practices for attaining and managing the goals. Check it out. Namaste!

Friday, August 10, 2018

Smiling sorrow – The repercussions of masking chronic anxiety

Guest Post from Ariel Taylor

Many people outwardly display happiness and exuberance. In reality, they may be concealing inner turmoil and depression. Depressive people fear that others may notice they’re flawed personalities. They fear people close to them may become judgmental if the depth and intensity of depression is revealed. People try to avoid being labeled as a depressive character or manic worrier as that becomes the quickest route to social and workplace isolation.

Hidden anxiety could provoke obsessive behavior or impulse control disorders

Hiding worries or repressing negative emotions may be a big mistake because the underlying anxiety could provoke OCD and body focused repetitive behavior such as Trichotillomania (TTM) which is a compulsive hair pulling disorder triggered by deep seated anxieties that people avoid confronting. For more information on Trichotillomania and treatment options visit TrichStop.com.

The worst assumption depressive people make is to believe that the dark mood is just a phase, a passing cloud, or momentary discomfort that will go away if they chose to ignore it. Avoidance only generates a wave of loneliness and unremitting sadness. This is the harsh reality of smiling sorrow.

Environmental factors that encourage anxiety repression

The behavioral quirk of concealing depression is more widespread than society thinks. It has a lot to do with the way we are conditioned to hide our innermost feelings. Society encourages people to become an agony aunt, a kind of sounding board (or battering ram) for others to unburden their sorrows. Somehow, we don’t enjoy the same freedom when it comes to sharing our personal feelings of loss and anguish and seeking help for the same.

This is a good time as any to reflect whether you or maybe someone you know is falling prey to smiling sorrow. If matters are not brought under control, it becomes difficult to control obsessive compulsive disorders that erupt collaterally.

Six sure signs that people are hiding anxiety

1. Viewing life through the harsh prism of intense pessimism
According to the American Psychological Association (APA), depressed people tend to view their lives more negatively than normal people. Such people are programmed to latch on to the negative aspects of their lives, and the problems that plague society around them. Depressive realism describes this attitude. Such people take on a realistic view of their situation and how it impacts their lives, but their analysis is heavily tinged with pessimism.

Normal people, on the other hand, tend to have realistic expectations and temper their world view with optimism. Depressive realism fundamentally changes one’s attitude from “Sara will definitely achieve her goals, given time and encouragement” to “I’m pessimistic about Sara’s chances of achieving what she desires.”

Action point: Keep the conversation positive and gently encourage people to view their situation in a brighter light.

2. The happy countenance hides behind a stream of excuses

The signs are unmistakable; the individual seems to be forcing a smile. As you spend more time with this person, the mask drops sooner than later. To hide their depression from prying eyes, such persons spend as little time as possible with others, preferring the anonymity of isolation. The excuses come fast and thick why they cannot meet you, come for dinner or attend a function. It’s only a genuine heartfelt conversation that unearths the depression and gets the person to spill the beans on what anguishes them.

Action point: Break the barriers of isolation and encourage the individual to engage socially with you and mutual friends.

3. There’s a conscious attempt to escape from the realities of life to philosophical thinking

Speaking to these troubled souls, you get the feeling that they wax philosophical about abstract topics such as their goals in life, and how they struggle to find meaning and purpose in their lives. A little probing might reveal hidden thoughts of violence, fear of death and the urge to inflict suffering on imagined foes. Theirs is a constant search for happiness without the willingness to tread the path leading to fulfilling lives.

Action point: An emotional plea and a spiritual renaissance would do wonders to dispel the darkness within these souls.

4. Binge eating, addictive behavior, and sleep disorders may indicate hidden turmoil

Any behavioral change that sharply deviates from the normal may indicate hidden depression. Sound sleep is essential to physical, mental, and emotional health. Changing sleep patterns are reliable signals of distress. Too little sleep or excessive sleeping both signal silent suffering. Clinical studies prove that sleep deprivation can aggravate depression.

Where the normal person eats frugally to live, a depressed person may find himself living to eat. The urge to binge frequently beyond normal cravings creates a feeling of fullness that calms the depressive mind. The problem is worsened by withdrawal symptoms following alcohol or drug intoxication. On occasion, the extreme opposite may happen - total disinterest in food because there is ‘no joy in eating anymore.”

Action point: Encourage such persons to follow a proper diet, juxtaposed with plenty of exercise and fresh air to drive away the cobwebs of despair.

5. The depressed soul is desperate for assistance, but will fight shy of asking for help

Chronic depressives will be mortally scared of revealing their darker anxieties and will fight tooth and nail rather than disclose their mental handicap. The fear of being exposed makes them retreat into their shell of exclusivity. On the rare occasion they open up, you will catch a glimpse of a troubled universe. In such moments they may respond to persuasion either to seek personal help or professional counseling.

Such individuals may end up knocking on the doctor’s door, only to retreat into their world thinking that they’ve gone too far, and others may judge them poorly. The very thought that another person would be probing their weak spots discourages many from seeking the help they desperately need.

Action point: Handhold the person through personal or professional counseling, assuring them constantly that it is for their benefit.

6. The depressed soul exists on an emotionally hypersensitive plane

It is the norm for the depressive mindset to express emotions strongly. Such individuals could suddenly break into a flood of tears on watching an emotive reel life episode. They become unduly aggressive in the face of the slightest provocation, situations that normal people would calmly ignore. The close friend who is unusually calm may suddenly express his abiding love for you. It is as if the troubled soul has boxed up so many depressive thoughts inside that genuine emotion somehow escape through the gaps to see daylight.

Action point: When such individuals hyperventilate, respond calmly and allow them to seek emotional fulfillment. You can always try humor to bring the situation under control.

The Bottom-line: One cannot assume that each of these symptoms is a definitive sign of hidden depression. Some people are naturally introverted or introspective or irritable. What you need to watch out for is chronic worrying mentality that could aggravate more dangerous as obsessions and impulse control disorders. When you see this happening, you need to step in and take corrective action.

Thursday, July 26, 2018

Top 10 States for Nurse Salaries when Compared to Cost of Living

Sharing some valuable info...
According to the latest data from the U.S. Bureau of Labor Statistics, the median salary for RNs nationwide is $70,000, while for LPNs it's $45,030. You may be wondering, in which states can I do better than that, and what type of expenses should I expect?
EasyNCLEX.com, a provider of NCLEX exam practice, recently conducted a study to find out. The study looked at the median salaries of Registered Nurses and Licensed Practical Nurses. The salary for each state was then compared to its cost of living index.
The salaries in the table below are taken from the latest U.S. Government statistics from May 2017. The cost of living data is taken from the 2017 cost of living index as reported by the . Missouri Economic Research and Information Center. Cost of living percentages are in relation to the national average.

Top 10 States for RNs

Cost Of Living
104.7 %
99.7 %
95.6 %
91.2 %
89.7 %
New Mexico
94.9 %
90.8 %
107.1 %
97.2 %
141 %

Top 10 States for LPNs

Cost Of Living
89.7 %
104.7 %
102.9 %
New Mexico
94.9 %
97.2 %
91.2 %
107.1 %
102.3 %
95.6 %
From StudentLoanHero.com here's a great list of top cities for nurses who have big student debt to pay off.


Thursday, June 28, 2018

Nurse Entrepreneurs Helping Nurses Find Direction in Their Career Paths

I recently sat down with a couple of nurse entrepreneurs to talk a bit about me and my nursing career, but also about nursing in general and hopefully provided some insights for those considering a career in nursing or looking for a new path for their nursing career. Health care is a challenging industry to say the least and nursing is never an easy occupation.

For young people today, I think nursing is going to have a few new challenges. Nursing is a service profession and you really need to be passionate and serious about helping people if you want a career in nursing. It's all about the patient and patients are never at their best when they don't feel well. That's something to really think about. Especially if you don't like dropping everything to go help someone else!

The first interview was done via Skype with Cara Sevier on The Not Just Nursing Show. I would suggest you close your eyes and listen. I don't play well to the camera! My eyes wander too much!!! But it was a fun time and worked out well for her first time Skype interview. She's in the eastern US and I'm on the west coast so we couldn't do it in studio as she does with many of her guests. Check out her previous guests and subscribe to her You Tube Channel.

The second interview was with Patricia Ramsey Laramee of the Nursing Assistant Podcast. We had some technical difficulties which just added to the learning process and the fun! You only have to listen, it's a podcast and she's had some really great guests so be sure to listen to all of the episodes., and Subscribe on Spotify or iTunes.  I hope we inspired some CNAs to consider continuing their education and becoming RNs in the future as we discussed my roles away from the bedside in home health and hospice.