Scrubs - The Nurse's Guide to Good Living» Sean Dent

The tough love of nursing

Sean Dent — Wed, 28 Jul 2010 15:42:02 +0000

It’s a dirty job, but somebody’s got to do it. Yes, I’m being both facetious and literal. Dirty as in messy: I won’t even elaborate on some of the ‘fluids’ and ’spills’ we nurses have to clean up. Dirty as in being ‘firm’ or dare I say ‘mean’ is also in our repertoire. Sometimes in order to get our message heard and for our patients’ to simply ‘get it’ we have to start not taking “no” as an answer and become the closet drill instructor we know we all can be.

Recovery from an illness is tough, no doubt about that. It’s painful, stressful and exhausting. Your body is taxed beyond its measure and then in order for it to heal it has to work twice as hard. The hard part about recovering from any illness is understanding the concept of ownership.

Most patients expect the very best from us and our medical team. They expect the medical team to ‘fix’ them. No matter how small or great the ‘illness’ is, we are supposed to fix them and make them all better. Patch them up ‘as good as new’. Unfortunately there comes a point of (no return) critical mass when the recovery process can progress no further without the help and motivation of the patient themselves. We simply cannot do it for you.

We can’t deep breath and cough for you. We can’t get out of bed and ambulate for you. We can’t do your active and passive exercises for you. Put simply, we can’t be you.

Sooner or later the ball will be in the patient’s court. Sooner or later their recovery will either move forward or stand still based on their actions. When these actions are not being done, when the patient finds every excuse imaginable to not take ownership for their health while still in the hospital – that’s when the tough love of nursing shows up.

Yes, we will get mean. We will harp on you. We will annoy you to no end. We will check up on you repeatedly. We will ask you to go above and beyond what you think you can or cannot do. We do all of this to get you better. You may think we are torturing you. Heck, you might even think we have it out for you and we just don’t like you. The truth is it’s all for your benefit. You may not understand it, you may not see it or comprehend it at the time, but all our torturous ways are delivered with the hope of getting you better, getting you out of the hospital and getting you home.

Because in the end, isn’t that what we both want?

Eating after curfew

Sean Dent — Fri, 23 Jul 2010 15:48:39 +0000

Image: Hemera | Thinkstock

This lovely myth still entertains me to this day. The old saying, “Don’t eat anything after 9pm”. Or 6pm, 7pm, 8pm, 10pm etc. It seems that actual ‘time’ has changed over the years, but the same principle applies. If you eat too late at night, all that food you ate goes straight to your (your gut, thighs, rear, arms).

Just like all the other myths out there, I’m sure this spawned from some eccentric weight loss champion or self-proclaimed health expert touting that your metabolism apparently ’slows-down’ to a crawl-like pace, and that any calories that you take in are simply not going to be consumed, but instead stored! So whatever you do, don’t eat late at night!

Grr.

It’s not about WHEN you eat, it’s about WHAT you eat. I’ll say that again. Gaining weight has absolutely nothing to do with the time of day, it has everything to do with what you are eating! Plain and simple.

Yes, I don’t think it’s a smart idea to eat a full meal late at night, unless you are a night owl, or maybe working the graveyard shift. You should be sparing with your portion size, and of course be conscious of your food choices, but by all means don’t stop eating simply because it’s a certain time of the day!

It doesn’t’ matter if you eat a jelly donut at 9am or 9pm – it’s a bad food choice! Remember, garbage in = garbage out.

The next time you are looking at the clock and worrying about the time, turn your focus to what’s on your plate.

Carpe Diem!

Is gastric bypass surgery worth it?

Sean Dent — Wed, 21 Jul 2010 15:53:30 +0000

As a nurse, I’ve seen and taken care of a few (insert sarcastic gesture) patients who have undergone one of the many different types of gastric bypass surgery. I’m not here to discuss the many different options when it comes to choosing which ‘type’ of bypass surgery is better or worse. I’m here to ask if having surgery to lose weight is really worth it?

Gastric bypass surgery (Bariatric Surgery) has been around for quite some time now (sorry don’t know how long). It’s obviously an alternative to the traditional means of weight loss. I’ve always viewed it as a ‘last ditch effort’ for all those individuals who are wanting to lose weight because of impending and debilitating health conditions that are robbing them of a safe and functional life. It’s for those morbidly obese individuals, at least that’s what I used to think.

Recently I’ve seen just the obese population electing to undergo these surgeries?? Yes, just the over weight population. Those individuals that just want to lose weight – who aren’t happy with their current weight. No, I don’t have exact numbers, or statistics. All I can say is they aren’t what I consider in the ‘last ditch effort’ category.

I’m still trying to understand and comprehend why someone would want or elect to have this surgery? I wholeheartedly understand the concept of wanting to eliminate the obesity and all the difficulties that go along with it, but to have surgery??

Surgery is a big step. A big and risky step. Surgery all by itself is risky. You have the anesthesia risks. You have the complications of infection as well as the recovery that is involved. I won’t even mention the possible side effects and complications of the surgical changes done to your body!

The recovery process is – to put it bluntly – brutal. You have to follow a strict diet plan that is done in increments. You will have to recover from the ’surgical’ portion of this puzzle, then have to battle all the stipulations of your strict new lifestyle.

You will have a new type of diet regimen. You can or cannot have certain foods, as well as how much you eat in one sitting. You will have to start an exercise regimen. Your new lifestyle will be tough, grueling and imminent. If you don’t follow any and all the expected stipulations you have a risk of reversing or damaging the surgical procedure. Worse yet, causing damage to an array of anatomical and physiological structures! Any deviation from the rules can and will cause physical damage that could require additional surgery!

Surgery versus traditional means always puzzles me. So here is how I broke it down between traditional and surgical weight loss:

Traditional

Must follow a healthier lifestyle
Some type of exercise regimen
Better food choices
In it for the long haul
Will see small incremental changes over a long period of time, but will get permanent changes
If you slip up with your regimen, you simply start over.

Surgical

Must follow a healthier lifestyle
Some type of exercise regimen
Better food choices
Must only eat certain food
Must only eat a certain amount of food at once
In it for the long haul
Will see immediate changes – will have to make changes over a long period of time, but will get permanent changes
Surgical procedural risks
If you ’slip’ up with your regimen you can cause physical harm.

Once again, please take all this with a grain of salt. There are definitely individuals that need this surgery in order to better their health and save themselves from shortening their life. Obesity can be deadly, short term and long term.

Is the risk really worth it?

Nurses and healthy relationships

Sean Dent — Mon, 19 Jul 2010 15:51:52 +0000

Image: iStockphoto | Thinkstock

It starts in nursing school and rolls over into our daily career work. Being a nurse is tough, it’s demanding and exhausting. We give our all to our job and to our patients, unfortunately sometimes we don’t have anything left to ‘give’ at home with our loved ones.

Our relationships are strained because our significant other may not understand that just because our shifts end at a certain time doesn’t actually mean we’ll be leaving at that time. We are equally as guilty when we don’t have the patience when our loved ones just ‘don’t get it.’

In the end, your job and your career are not where you hang your heart. Your home, your family and all those who matter to you deserve the same dedication that you give your job. The crazy thing is, if we started to handle and treat our loved ones the same way we treat our job and our patients, the so-called ’strain’ would disappear.

Here are a few tips for keeping your relationships ‘healthy’ by treating those you love like you treat your patients.

You were born with two ears and one mouth

You should listen twice as much as you speak. I think we all learned this in Nursing 101 – therapeutic communication (sound familiar?). Listen to what your loved one has to say before you decide to interject with your opinion. You’d be surprised what they have to say.

Next: Speak on their level. Equality is stronger than brutality…

Stay hydrated and stay healthy

Sean Dent — Fri, 09 Jul 2010 09:18:49 +0000

Image: Christopher Robbins | Photodisc | Thinkstock

I thought it only appropriate to address proper hydration during such ‘heat wave’ –like weather (at least where I live right now). Most people will of course increase their fluid intake when it gets super-hot outside, but it’s not just while you are outside. You should be keeping yourself well hydrated even when indoors (like when you are at work!). Besides, you’re body loves to remind you when you are dehydrated in the form of body aches, headaches, loss of energy, slower response reflexes, decrease awareness, etc.

Sweating along with the thirst reflex are your body’s last responses to overheating (yes, I know my fellow nurses are aware of this), but for some crazy reason we use them as a marker for when and how often we should drink fluids. It’s a standing joke at work right now that I’m well hydrated. I drink close to 3 quarts of fluid during my typical 12 hour shift (along with the occasional cup or two of coffee- yes, I have my vices). I drink so much so often that my visits to the restroom are now a source of ‘ribbing’. 3 quarts of water have to go somewhere!

*clearing my throat* – anyway!

With all that being said, do you know how to measure if you are properly hydrated? There is a cheap and easy way to figure it out. Ironically I blogged about it quite some time ago on my personal blog. Check it out:

How do I know I’m hydrated?

So we all know about the recommended daily intake of water. Somewhere around 8 glasses of water. Their are a ton of websites and tons of information on how much and what kind of water you should drink. Then you have the bottled water vs. tap water debate. I think it’s safe to say we all know the benefits of water.

The human body’s percentage of water is somewhere in the range of 65% or higher. I think I read an article that it can be as high as 78%. The take home message being that your body makeup is more than half water.

So it’s safe to say drinking water is good for the body. Drinking more will definitely hydrate your body. As to how much and how often we won’t debate (at least not today on this post) We also won’t even skim the surface on the debate of water vs. sports drinks either.

I wanted to talk about how to monitor or measure your body’s hydration. I want to share a quick-fast and easy way to determine if your currently hydrated and how to measure if your hydrating yourself adequately. Now this lil’ trick does not exist in a bubble and is in no way a substitute for true medical advice and medical analysis, but it’s an easy and inexpensive trick.

It’s really simple. Look at the color of your urine. Is it dark or light? I really don’t care about the shade of yellow or amber, but more importantly how clear is it? Is it really dark or does is it almost take on the consistency of… uuhhmm I don’t know … water?

The more hydrated you are, the closer your urine will look like water. Pretty simple huh? How can you forget that one!?

Now there are some important facts to note while using this little trick:

Let me reiterate this method does not exist in a bubble, there are a million other factors out there that can affect the color, smell and consistency of your urine.
Yes diuretics and other popular drinks (soft drinks, cola, sports drinks, tea, coffee, etc) can and will give you the clear urine, but you may not be hydrated. So don’t expect to drink coffee, or tea and be hydrated. Some drinks like coffee and tea act like a diuretic and can inhibit a hormone in your body, therefore causing you to urinate more and more often.
Just as what you drink affects your hydration, so do the foods you eat. Just imagine the amount of sodium content in a can of processed food.
Yep your physical activity plays a HUGE role in your hydration, as well as how much you sweat. Everybody sweats differently. (I sweat standing in 30 degree weather and my wife doesn’t ever perspire until it’s almost 100!)
Drinking more water will definitely make you pee more!!!! But trust me, barring you don’t have any pre-existing medical conditions, your body will adapt and you won’t urinate quite as often.

This is great for determining your level of hydration as well as monitoring if your ‘becoming’ hydrated. Is all that water helping you hydrate? It also lets you know just how dehydrated you really were.

So, how hydrated are you?

I guarantee you’ll never visit the restroom the same again. Isn’t nursing fun!?

How do I know I’m hydrated? Originally posted on My Strong Medicine

The feast or famine phenomenon in nursing

Sean Dent — Tue, 06 Jul 2010 18:04:06 +0000

This is the one thing I dislike about nursing. OK. OK. Maybe dislike is a strong word? Maybe – I’m not a big fan of?? Does that sound better?

Now this particular ‘thing’ about nursing only seems to happen in the smaller rural hospitals (at least that’s what my experience has been). I truly am not a fan of the ‘feast or famine’ phenomenon.

Feast or famine: You as a nurse are either running your rear end off to the point where you didn’t have time to relieve your bladder or eat any food. OR – things are so slow you find yourself staring at the clock. The census on your particular nursing unit is either busting at the seams or you can hear an echo down the hall.

Now we all know how most nurses (including myself) feel about that horrible ‘Q’ word. You never say quiet, or bored while at work – Murphy’s law will definitely slap you back into reality if those words are spoken. You’ll either have a patient’s condition go sour, or you’ll get a handful of admission back-to-back, etc.

This past holiday weekend was my weekend to work. Neither good nor bad, just was. It was ‘my’ weekend in the rotation. Well I guess everybody in my community decided to get well and heal themselves?! Better yet, during the weekend, they avoided the hospital and the Emergency Room?! The entire hospital census (including my nursing unit) was at an all time low. Far be it from me to complain about people getting better, but I tend to think it had something to do with the warm weather, the holiday, and of course the long weekend.

Once again I’ll be the first to admit it was a nice change of pace, but I think that’s where the appreciation ends. Inevitably to save on costs and the budget someone gets put on call, or gets cancelled. Now – once again who wants to complain about that? But, both of those actions will definitely hit the pocketbook eventually.

I’m probably going to catch a lot of heat for my gripe, but I’d love for there to be some consistency in the roller coaster ride. Yeah, I know – I’m asking for a lot.

Do you have any similar experiences? What are your thoughts?

Losing weight one spot at a time

Sean Dent — Fri, 02 Jul 2010 16:52:42 +0000

Image: Goodshoot | Thinkstock

There is quite a large population of people out there that believe spot reduction works (*GASP*). Yes, some if not a lot of the general public still believe that they can lose weight focused on a certain area of their body.

“I just want to lose a couple inches off my waist”

“I want to get rid of that flab on my arms”

“I need to thin out my thighs”

All of this stems from those darn info-commercials you see on TV (I seem to remember seeing them on Sunday early morning). The Thigh Master, Ab Scissor, Step Master, etc. They all promote weight loss to a specific area of the body. If you do this exercise or that exercise you’ll lose that unwanted extra weight from that body part or area of the body that your are exercising. I also think this is where the crazy idea of ‘do sit-ups to get that toned abdominal area’ originated from (GEESH).

Spot reduction is one of the greatest fitness / weight loss myths out there. It’s such a great myth that people literally ‘buy into’ it with those ridiculous machines.

It’s just a myth, nothing more. Some may believe that a certain body part loses more weight than the other due to the exercise or exercises they did, but the truth of the matter is we have no control over where we lose weight. It’s all about the whole, not the parts. Our weight loss is pre-determined by our genetics and our overall health regimen. We have as about as much control over spot reduction weight loss as we do the weather.

Weight loss is the exact reverse of weight gain when referring to your overall body and their respective areas. There are of course minute differences in men and women, age, medical history, etc, but as a whole it’s pretty predictable. We gain weight in our mid-section, then our back side & thighs, your arms and lastly your face & neck. So when losing weight it’s the exact opposite. This is why when people start to lose weight we immediately notice a difference in their face. It’s also the very reason why that ’stubborn’ mid- section is the source of much dismay when traveling down that path of weight loss. We always think we are doing something wrong because we are not losing the weight where we want it gone the most!

Isn’t it funny, we want to eliminate weight from the very areas that take the longest to lose and the quickest to gain!

The next time you see or hear someone talk about losing weight from a specific ’spot’ be sure to let them know about this myth.

Nursing 2.0

Sean Dent — Mon, 28 Jun 2010 21:49:44 +0000

Yep, I’m stealing another phrase. But this time it’s sort of borrowing a term – Web 2.0. Web 2.0 is a term that was coined in the early part of the new millennium. It was used to describe the ‘new’ internet after the ‘fall’ of the dot.com ‘bubble’. In laymen’s terms it’s the new internet versus the old.

The old internet (for those of us who actually used it back then) during the mid-90’s was a very different experience than what we are used to now. No, the internet itself and it’s inter-workings did not change, but the way we use it and the way we interact with it HAS. Does anyone remember the old Yahoo! or Google page? It was just a ’sheet of paper’ with links (the infamous web portal). It was static, had no interaction with the visitor and it basically pointed you in a direction you were looking for. Nowadays Google, Yahoo! and the like are all about user connectivity and interaction. You get to be a ‘part’ of the page with customization, interaction and contribution. I won’t bore you with all the ‘geeky’ details but if you’re interested in learning a lil bit about this awesome phenomena visit the following links

http://oreilly.com/web2/archive/what-is-web-20.html

http://en.wikipedia.org/wiki/Web_2.0

And here is a wonderful video that sums it up quite well:

http://www.youtube.com/watch?v=6gmP4nk0EOE

So why am I boring you with geek-talk? Because nursing is following in the web’s footsteps. It seems that slowly but surely the ‘career’ of nursing is transforming. We are seeing in front of our very eyes. Everything from online classes and dedicated online degrees (including advanced practice nursing), online scholarly documentation systems (research), electronic health record (eRecord), online journals, webinairs (for CEU’s), virtual chat, telehealth (virtual stroke team), telenursing, web conferencing, web chat, instant messaging (twitter), and of course the very reason you are reading THIS website and my blog! It’s all a part of nursing growing upwards and out. Nursing is evolving into the state of the art system we all hoped it would be.

What sparked my idea?

I was attending an information session for possible graduate school admission this past week. During the conference it was explained that all graduate students will be required to possess a ‘hand held device’ and purchase certain medical programs to utilize during their clinical rotations as well as for classroom activities. Gone are the days of lugging around 6 books for pharmacology, physiology, assessment, etc weighing in excess of 500 pounds. Now you will carry around an electronic device no bigger than the palm of your hand that will possess all that information and more (including internet access) all at your fingertips to help assist you in your learning process.

The future is bright.

Change of Shift (Santa Fe Style!)

Sean Dent — Sat, 26 Jun 2010 23:05:19 +0000

The latest installment of Change of Shift is up over at Digital Doorway

All the way from New Mexico! Keith has returned from his new home to host our beloved blog carnival.

I really hate how horrible I am lately, not submitting a post.

As always a BIG THANK YOU to Kim over at Emergiblog for getting the CoS party started, and keeping the fire going!

Carpe Diem

Note: Originally posted on My Strong Medicine.

Permalink

Embarrassed to go to a gym?

Sean Dent — Fri, 25 Jun 2010 22:09:15 +0000

Image: Digital Vision | Thinkstock

This is a toughy. At one point or another, at one time or another EVERYONE has had this challenge. It’s one thing to decide and want to improve your health and fitness, but doing it in front of others brings about a whole new set of emotions. It’s not enough that we don’t like how we look (and feel), but going to the gym and seeing those ‘in shape’ and ‘fit’ individuals sure doesn’t give much motivation to subject yourself to the public eye.

Gym-goers are funny like that. We have this crazy belief that everyone around you in the facility is ‘watching’ you, critiquing you, and maybe (dare I say) laughing or making fun of you.

I can remember when I first went to the gym, when I was at my heaviest. I was embarrassed to lift the weight I lifted. I was embarrassed at how short of time I lasted on the treadmill and/or elliptical machine. And, I hated how I looked in the clothes I was wearing. I wouldn’t dare wear a tank top or a sleeveless shirt and reveal my embarrassing physique (at least in my eyes)!

It was all in my mind.

No one was staring at me. No one was talking under their breath as I walked by. It bothered me so much in the beginning that there were days I didn’t go inside. I’d drive to the gym and turn around. No one was laughing at the weight levels I chose on the machines I was using. No one cared. Except me.

It’s that horrible psychological warfare I’ve talked about before. You must first win the battle inside your head before you can win the battle of your body. We are truly our worst enemy, and our greatest cheerleader. The only difference is deciding who shows up everyday in your head. It’s a simple choice.

In the end you have to come to terms with what you and your mind are arguing about. It’s about loving yourself enough to brave the unknown and uncomfortable. No one said it would be easy, anything worth doing never is.

Here are a couple key things to keep in mind when you’re battling with the embarrassment:

Nobody is perfect.

Not even the fit guy or gal you see all the time at the gym. Having a goal is great, but make sure it’s YOUR goal and not someone or something else. Having a goal of wanting to look like someone else is not you. Strive to simply improve upon what you already possess.

Everybody started where you are.

Yes, yes they did. Whether they admit it or not, whether you want to believe it or not – we all had to work at getting where we are today. While some had it easier, we all had to start from the same position. We all had to conquer our fears.

Sweating is cool.

It’s not only cool, it’s down right respected. When given the choice between a not-so fit person sweating their keister off and Mr/Mrs Universe enjoying a look at his/herself in the mirror I’ll choose the person busting their rump. I have more respect for the individual trying than the individual showing off.

You are not alone.

Contrary to what you may think, most of your fellow gym-goers are also your best cheerleaders. At one time or another a fellow member helped them, and if you have the courage to ask or the chagrin to accept criticism it will provide you with invaluable tools to get you one step closer to your goals.

We really don’t care.

It’s really not about you (wink). Seriously, we’re not staring at you. If anything we are reveling in the idea that we are no longer the new kid on the block – you are. Welcome to the club.

It’s all about you.

In the end, your success and failure is your responsibility and your own fault. Taking no for an answer, reaching out for advice, asking for assistance, and paying attention to what works and what doesn’t are the keys to unlocking your body’s potential. Oh and that lil thing called courage.

Best of luck on your journey!