The Dog Ate My Care Plan…

Just a mom/wife/nursing student extraordinaire trying to make it in the big bad city…

Archive for September, 2010

My Strong Therapy

Posted by isntshelovlei on September 28, 2010

You know you’re into the meat of your nursing program when the concepts start to creep into your everyday life. You assess friends and familys’ vital signs…you are now a germaphobe and engage in scrupulous handwashing (and encourage others to do the same)…you might even use medical terminology in every day conversations (I’ve been known to say things like, “Well I do XYZ prn…” or complain that my son is “noncompliant” with some rule). One could imagine it would only be a matter of time (especially now that I am taking mental health/psych) before the therapeutic communication would begin to kick into auto-pilot.

I have three kids. It was the weekend and I was trying to study (of course) so I let them go outside so that I could have a smidgen of peace. My daughter comes back in the house huffing and puffing, eyebrows knitted. I sighed and put my books down. The conversation went a little like this…

ME: “What is the problem now?” (giving broad openings/open-ended question)

HER: “He thinks he’s the boss of me!!”

ME: “He thinks he’s the boss of you?” (reflecting/restating)

She nods.

ME: “He is only 11. Do you think he’s old enough to be anyone’s boss?” (voicing doubt)

She thinks it over for a minute (silence), then makes a face.

ME: “Well? Go on…” (general leads) 

HER: “No…but he still acts like he is…” she grumbles.

ME: “I know, sometimes big brothers are just difficult like that. But if you ignore him when he acts like that he won’t do it as much (supportive confrontation). Please stop fighting with your brother. If the two of you can’t get along, you will have to come back in the house (limit setting)…

Sufficiently unruffled, she goes back outside and all is well with the world.

Until next weekend…

Posted in Family, Nursing school | Tagged: , , | 4 Comments »

Quicksand…

Posted by isntshelovlei on September 21, 2010

I just wanted to do a quick post to let everyone know I am not dead and have not abandoned my blog. I have just been completely swamped with trying to get a handle on this semester.

I started my psych clinical this past weekend and all I’m going to say about that is that I’m trying to keep an open mind… Let’s just leave it at that—for now anyway.

In other news, I was awarded another scholarship!! I was selected as a 2010-2011 recipient of the Charlotte W. Newcombe Foundation Scholarship for Mature Women Students. In these tough economic times, I am always grateful for any additional assistance and support as I fight the lions, tigers, and bears of nursing school…

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Insights in Nursing Podcast, Episode 14

Posted by isntshelovlei on September 17, 2010

Yet again we have more doctors voicing their “concerns” about the apparently very intimidating “Doctor Nurses” (*enter scary music*). Le sigh. I plan to eventually pursue my DNP. Do I plan to have my patients address me as “Dr. IsntSheLovlei?”—absolutely not. I am however, likely to display my shiny new credentials on my letterhead, my lab coat that I’ll sling over the back of my chair (as if I would ever really wear one of those things), or perhaps even on a paperweight on my desk.

I honestly think some our doctor-friends are hiding behind this whole “you’re going to confuse the patients” excuse as to why they are so against nurses with doctorates. What is the problem really? Afraid of a little friendly competition? Think an increasing number of patients will be drawn (if they are not already) to the more holistic model of care that nurses provide? But it’s not like we’ll be taking food out of your mouths—there’s actually a shortage of primary care physicians. Advanced practice nurses are willing and more than capable of helping to fill that void. As far as confusing the patients—I think that patients are less concerned with the alphabet soup behind your name and more so with the excellent (or not so excellent) care that you provide. JMHO.

Check out our discussion of this topic and more on the latest episode of Insights in Nursing with Cora Vizcarra from the Infusion Nurse Blog, host Jamie Davis also of the Nursing Show and MedicCast, and of course—yours truly.

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Insights in Nursing Podcast, Episode 13

Posted by isntshelovlei on September 10, 2010

Has the whole autism-vaccine controversy finally been put to rest? With the internet and so much bad information (and bad publicity by pearly-teethed former Playboy playmates) so readily accessible to people nowadays, will fears now begin to subside? 

Colorado, will now not only be known for its rocky mountains, but for their rocky viewpoint as well (though I guess everyone’s entitled to their opinions…). Apparently, a group of anesthesiologists in Colorado have their panties all in a twist at the thought of nurses, not doctors, making “life-and-death medical decisions” for patients (the gall!!).  I’m not even a nurse yet, and I was personally offended. Can’t we all just get along?… Le sigh. 

And last, an Australian nursing school unveiled an awesome “Women Who Shaped Nursing” display for History Week. Truly a beautiful thing. I’m all about honoring those that paved the way. But what about our male nurses? What about the men who helped pave the way for the military to allow male nurses in the service?  James Derham, who worked as a nurse to buy his freedom? Most people don’t even know that Walt Whitman was a nurse—only that he was a writer and poet. There are many men in the history of nursing—but few people know anything about them because we only talk about the women in nursing. Check out our discussion of these topics and more on the latest episode of Insights in Nursing with Kim from the Emergiblog, host and jack of all trades Jamie Davis, and a scratchy-throat-catching-a-cold yours truly.

Posted in Current Events, Nursing | Tagged: , , , , , , , , | Leave a Comment »

I Don’t Know It All

Posted by isntshelovlei on September 6, 2010

Do you ever feel like you are treated a little differently because you’re a nursing student, nurse, or other health care professional? For example, are you provided with less patient education because people know that you work in health care and “assume” that you already know certain things? Or is patient education just not occuring as much as it should in general and we just notice it more because of our background?

For instance, one of my kids had a physical last week. Towards the end of the visit her doc mentioned that they had the flu vaccine (already?!?—it’s still like 100 degrees outside!) and that she should get it today. It was less of a question—she basically assumed that I would want my child to get the vaccine. And my silence I suppose, was implied consent. Why wouldn’t I you/she might ask? That is a post for another day…

Anyway, the physical is completed and the doc says as she leaves that the medical assistant will be in to give the vaccine. No “do you have any questions?” No “is she allergic to eggs?” Now I know that an egg allergy wasn’t documented in my kids’ EMR, but still it’s just a computer program—there are glitches and cooties and sometimes computers are just blatantly stupid. And there’s really no way that out of the hundreds of patients that she has she remembers my one little daughters’ allergies. I thought you were always supposed to (or maybe it’s just best/better practice) (re)confirm things like allergies at every encounter, especially when administering medications/vaccinations.  And don’t some people develop allergies over the years?—you’re not always born with them. I’m just saying… But I didn’t stop her from leaving since I did happen to be comfortable with my level of education regarding flu vaccines. Besides—sometimes I just like to sit back and watch these things play out. Personally, I know how to ask questions when I want to. I am more than capable of making my needs known—just ask any of the early intervention agencies in my areas (poor things). My point though, is that some parents/patients DON’T.  And that’s why we still have people that believe that vaccines cause autism. Information, good information, is power.

So the MA comes in with the vaccine, squirts it up my kids’ nose (it was LAIV/Flumist), gives me the information sheet (after the fact), gives my kid a sticker and goes on her merry way. Meanwhile, I’m wondering, who does the education around here? Shouldn’t they really give you those information sheets BEFORE they shoot your kid up with something? What if I look over the info sheet and suddenly realize “oh sh!t” my kid is pregnant (don’t act like that couldn’t happen in these days and times)…she shouldn’t get it?!? What if I couldn’t READ the damn thing at all (but then again I’m a nursing student I guess I should be able to read)? What if English wasn’t my first language? Maybe I’m over-reacting, my critical thinking (and often fastidious) student nurse wheels a’grinding… But then again, maybe I’m not.

Now I know that the person that administered my daughter’s flu vaccine was not a nurse but a medical assistant. And I know that patient education cannot be delegated to a UAP (unlicensed assistive personnel for those not fluent in healthcare/medicalese). But shouldn’t someone be doing the education? I just think that regardless of your background things like patient education should be part of every health care encounter even if it’s redundant (unless declined). I had a nursing professor that would say “well i’m not a cardiac nurse so I’m not familiar with xyz…” And she was a CRNP! But it wasn’t her specialty, so her knowledge base wasn’t as wide in that area. People shouldn’t assume that just because you’re a health care professional that you know (or even more importantly, understand) every nook and cranny.

So honestly I really don’t know for sure if my being a nursing student really was the reason why we received so little (if any) patient education. But it wouldn’t have been the first time. During a brief hospital visit of my own, it was frequently implied that they didn’t need to explain things to me because I was a nursing student. Key word in that sentence—”student.” But even when I become a full-fledged RN I will not know everything. Not to sound cliche but, “you never stop learning.”

If the nation is really going to try to shift from “sick care” to “health care” and focus on prevention, patient education will have to be a large part of that. Might as well start practicing now…

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