image: © istockphoto.com/Tomasz Wojnarowicz

Have you ever uttered one of these phrases to a female nurse before? I’m not going to say I did…but you won’t be hearing me say them any time in the future. This is all fun and games, of course (except for maybe #1, let’s be honest)!

1. Bad hair day today?

This is not just because yours truly has no hair (although it doesn’t help). It’s all fun and games until the ‘hair’ card is pulled – then it’s a no-holds-barred war over why you think their hair looks bad. Did it always look bad? Is it the color? Is it too short? Is it too long? Should it be pulled up?… (this list is endless)

2. Is it that time of the month?

This should only be said from afar. If you’re close enough to be hit- you will be. ‘Nuff said.

3. Oh! Hey? Do you have makeup on?

This comment ranks up there with the hair comment. The fact that you have noticed something about their complexion will start a river of questions concerning whether or not they have always looked bad and why haven’t you said something before.

4. Do those match?

I always love the ‘void of knowledge’ most male nurses – heck, most men – have when it comes to matching. Oh – wait, maybe this is just me?

5. There’s no crying in nursing.

Yes this is stolen – have you seen the movie “A League of Their Own?” You gotta love Tom Hanks. And this can be quite debilitating. Be careful.

Of course this is all in fun. Don’t take any of this seriously, nor think for one second I or other male nurses would actually these mean and horrible things. It’s just fun knowing that we men working in an obviously female-dominated profession have a good grasp on our co-workers sensitivities.

It’s kind of like a married man knowing what to say and what NOT to say to his loving wife.

Right?

iStockphoto | Thinkstock

The recent advancement in medical technology is astounding, if you think about it.

We can view the inside of the human body to such a fine detail that the human eye has a difficult time deciphering the pieces. We can monitor physiological processes remotely. We can view and document just about anything related to patient care remotely.

I think every piece of new technology that’s come across the healthcare spectrum in the past two decades is one of those inventions you hate when it’s first introduced. In fact, you hate it so much you might be offended by the audacity that someone thought this invention would even work, let alone benefit healthcare.

The invention picks up steam and eventually is adopted as the “standard.” You go from hating it and refusing to use it to sluggishly accepting it. We all become Eeyore from Winnie the Pooh: “Hooo-hummm. I guess I’ll go ahead and use this.”

Eventually, life seems to improve due to the use of said invention, and you bashfully admit it’s worthwhile. But then something crazy happens: You actually start to like the invention.

You like it so much you become proficient at using it. Your job gets–dare I say–easier because of this technology.

The switch has been flipped. You love it.

Then something happens. The new technology–you know, the one you thought was the best thing since sliced bread–turns out to be fallible.

Not only is it fallible, it’s downright breakable. Breakable and useless, I tell ya!

Now that it’s out of order, you have no idea what to do. You have to pull from the depths of your memory what the heck you did before your new toy, err, technology.

Does this sound familiar to anyone? A few weeks ago, our electronic health record system went down. I can’t even begin to tell you how crazy it was trying to function without that “crutch.” We were writing physicians’ orders on real paper! We were faxing orders to pharmacies with a real fax machine! And we were charting on real paper! (Madness, I tell ya!)

It was as if the sky was falling and I was Chicken Little.

Thankfully, the sky only fell on us that morning, and by the afternoon we had our crutch back.

Hemera | Thinkstock

There’s been a recent surge and great interest in the “incivility in nursing.” I dare ya to do a quick search–go ahead and Google it. I’ll be here when you get back…

Incivility = violence = lateral violence = disrespect = offensive= etc, etc. In fact, I read an article that spoke of incivility as simply being mean. Mean? Really?

Better yet, I read another article that talked about actions that can be interpreted as ‘”uncivil” (incivil?), such as tardiness or sending an email without a greeting (be still my heart!).

I’m poking a little bit of fun at a real and serious problem. For some strange reason, the world of nursing thinks the problem is unique to its profession. Or that the lateral violence we experience is new or, dare I say, different.

I spent a good amount of time reading some of the leaders’ opinions, blogs, articles and presentations online. I have to admit, I’m still trying to understand the uproar here.

Incivility in the workplace is as old at time. The only difference is how it gets handled and whether or not it’s tolerated. The truth of the matter is that lateral violence or incivility will never go away. It’s everywhere–not just in the workplace, but also in our social circles, in our classrooms and in our homes. It can be less prominent or more severe no matter where you go.

I think therein lies the problem. Lately it’s become more severe in the nursing world. There are a lot of theories as to why, and they are all equally entertaining (at least to me).

1. Men vs. women (nursing is a female-dominated career)
Women are more sensitive and thus are “hurt” easily.

• How is it that women all around the world have survived in the medical community, then? Are you saying physicians are insensitive?

2. Women by their very nature can be catty
I have a hard time refuting this theory, since you don’t hear construction workers complaining about incivility. Men may resort to physical violence, but they aren’t diabolically vengeful (mostly!).

3. It’s the generation (Generation Y vs. Generation X vs. Baby Boomers)
Newer nurses feel “entitled”–they are “above” the basic bedside skills.

• I would have picked the word “spoiled.” And it’s not just the younger nurses who are guilty.

4. BSN graduates are entitled and have an ego
So you think because they advanced their degree, they forgot what it was like at the bedside? Or that they would treat a bedside nurse poorly because they have more letters after their name?

5. Newer nurses preoccupied with leapfrogging
Apparently, it’s viewed as an offense if a young nurse wants to advance his or her education? While neglect is rampant (no argument there), how is pursuing a higher education a bad thing?

6. Newer nurses have no respect
Have you heard the saying “nurses eat their young”? Since when is a bad thing if the young fight back? Respect is a two way street.

•  I think it has everything to do with you as a person (and professional) and how you deal with challenges. Period. It’s that simple. If you don’t want lateral violence to snowball, figure out a way to challenge it and deal with the root of the problem.

REALITY CHECK

We all need to grow some thicker skin
If someone offended you, don’t go tattling on them to your supervisor. Have the self-indignation to confront the assailant as a professional with your views, interpretations and explanations as well as suggestions to alleviate the occurrence from repeating. Do not turn into a high school teenager.

There should be zero tolerance from anyone holding a supervisory or leadership role
This includes every nurse who has more experience than the nurse next to them. I’ll say that again: You assume a leadership role the minute you are no longer the rookie. Period.

Newer nurses: Quit being so spoiled rotten
Just because you were coddled doesn’t give you the right to whine every time something didn’t go according to plan. Learn to roll with the punches. There is definitely a difference between self-assertiveness and immaturity.

Seasoned nurses: Quit being so vindictive and insecure
Leaving the bedside is neither good or bad, it’s just a decision to further one career. If you find it so offensive or appalling, keep it to yourself. Better yet, I dare you to try to take the same leap.

And lastly, this is for all the nurse leaders out there. If you really want to effect change, then quit with the academia-babble
Get out there in the trenches. Get your hands dirty (figuratively and literally). Quit creating new employer-based committees and developing action plans with continuum manifestos and evidenced-based theories. Walk the walk, folks.

Am I being blasé? A little too laissez-faire? Insensitive? Is it because I’m a man??!! (Ohh let the hate mail begin!) Or maybe, it’s because I don’t tolerate or accept the incivility when it shows its face.

I take a professional, head-on approach instead of whining, crying wolf and pleading with a “woe is me” attitude. There is a profound difference between being a victim and acting like one.

Let’s all put on our big-girl and big-boy pants and learn to play nice in the sand box.

Mehmet Can | Veer

I have one more year left of being a student, and still have a ton of knowledge to consume. But one thing I know for sure: Being a nurse practitioner student is equal parts excitement and aggravation.

The excitement is seeded in the information-laden state I’m in. Every day I learn something new and cutting edge, and yet so basic and simple to advanced practice. I’m a nurse learning to dip my feet in the deep, deep waters of medicine.

Just when I think I’ve got a hold on a subject, I get that slap in the face from reality. It’s tough being the new kid on the block sometimes.

The aggravation stems from the resistance nurse practitioners have been fighting for years. Being mid-level providers, the world of medicine seems to have drawn a line between support and rejection. To them, we are either here to help them deliver the very best evidenced-base care, or we are here to step on their toes.

I’m not sure why. I’m guessing some of the states that are lobbying for independent practice have struck a nerve in some areas. But once again, I’m still a student, I’m still learning.

Then there’s the offensive and degrading position some physicians have taken. I’m wondering if it’s a defense mechanism?

Today I was told by a physician that NPs are simply hired to do all the “scut-work” that physicians don’t want or like to do. In the physician’s words, “You guys do all the crap/garbage stuff we don’t like or have time for. Is that what you really want to do?”

It took everything I had to not resort to physical violence and/or verbal rampage. (Sorry, folks.)

No doctor, my career and my (soon-to-be) position in the healthcare system is not as your receptionist or your transcriptionist. I actually DO have a set of skills that can not only help you, but may, in fact, elevate the delivery of care to your patients. I am here to help you, not replace you or fill your shoes. I know my limitations.

Today’s healthcare team is supposed to be filled with forward thinkers. Unfortunately, this physician wasn’t one. It may be presumptuous of me to say this, but I think it had something to do with an “old dog learning a new trick.”

Am I wrong to think this way? I know that NPs and their function are gaining popularity and are becoming more widely acknowledged, but we aren’t that new to the block. In fact, NPs have been around for just shy of half a century. I suppose I shouldn’t be too upset by my experience, since it’s the first one of its kind. I guess the edge of the blade was just sharper than I expected.

leaf | veer

I think it’s safe to say not many nurses are 100% happy with their jobs.

There are a myriad of idiosyncrasies and challenges we face every day that make our jobs and responsibilities difficult to manage.

We encounter everything from staffing or equipment shortages to professional practice barriers and continuing education costs, just to name a few.

Nurses are notorious for ineffective complaining. The only way to effect change is to become less reactive and more proactive. It’s one thing to have a new idea or voice, but you need to have that idea and voice heard.

Here are just a few things you can do to effect change:

Practice what you preach

Be the one to set the example, and not the one being made an example of when it comes to practicing compliance and performing daily responsibilities. It can be as simple as wearing the proper uniform or following the simple “no drinks” policy at the nurse’s station.

Become a part of something bigger

This can be at the local or national level. Join a committee at your place of employment, join the local state nursing chapter, or register online for the ANA. Get involved and be heard.

Be a part of the solution

It will do you no good to be a part of the problem. Finger pointing and blame placing is a passive way of redirecting focus. Take the proactive step to enrich and elevate all those around you.

Share your ideas

I’ve mentioned this before, but I’ll say it again. I think every nurse out there should start a blog, join Twitter and participate in any other social media outlet available. It’s absolutely amazing how empowering it is to find others who can truly empathize with your passions. Whether anonymous or not, get your words out there.

Move up the chain

Advance your education however and whenever you can. Whether that means going back for collegiate work or gaining additional nursing skills, knowledge is power. That knowledge and experience also will help you move up the chain of command. Some of the best nurse leaders started out as highly motivated charge nurses!

In the end we all want to be heard–what better way to have your wonderful voice and powerful ideas put in motion?

Jochen Sands | Digital Vision | Thinkstock

The most powerful healing tool gets lost in the background to the buzzing, beeping, clicking and shuffling. The rhythms of a nursing unit set the pace of the day. An alarm sounding, a timer beeping, and a monitor blipping. Rush, rush, rush to the next task at hand, all the while treating our patients like another piece of equipment. I too am guilty of this sin. I get caught up in the moment. I worry about time. I am mindful of the roar.

Thankfully, I had the pleasure of getting back to the basics the other day at work. Due to staffing needs / wants and census changes at the drop of a hat I was floated to a neighboring unit to function as a nurse aide.

It’s no secret how I feel about that job and the angels that perform their duties on a daily basis (here and here) , so stepping into their shoes was a great opportunity to maintain my perspective.

I was reminded how powerful the art of ‘touch’ can be. During my shift, I lost count on how many bed baths I gave. Most of the bed baths were done at light speed by the end of the morning, but the first few of bed baths I was able to take my time.

During the bed bath I was able to chat with my patients, learn about them, talk with them about any and everything that was on their mind. I was also able to help alleviate many fears and concerns they were having about their hospital stay.

I can’t say I give the greatest bed baths. Heck, I’d be willing to admit I’m actually quite horrible at it (to this day I can never hold the darn hand towel correctly!). What I AM good at is having a soft hand and light touch. It’s a dying art in the present fast-paced world. But, having the ability to move a patient correctly, safely and gently holds more value to the patient than we care to admit.

One of the greatest compliments I got that day at work was from an elderly gentlemen who was making a slow recovery from a life-changing surgery recently. As I was cleaning up my ‘mess’ of dirty linens and tidying up his room he reached out his hand gesturing me to come closer. He took hold of my forearm ever so gently with his frail but firm hand and said, “Thank you. You did a good job”.

I gotta tell ya. I don’t think I’ve ever smiled longer.

I’m not sure he realized how powerful his touch was for me.

iStockphoto

This semester starts the strong wave of clinical hours for my Nurse Practitioner program. I’ll be spending many, many hours in the hospital as a student…again.

I’m just a tad bit nervous.

Okay, let me re-phrase that. I’m scared outta my mind!!

I feel like I’m back in nursing school–learning the ropes, talking the talk. Just when I started to find my own walking pace, I’m back to crawling at the next level.

I can’t help but wonder how different things are now from when I was in my diploma program. (I cannot believe it’s been seven years since I became an RN?!)

Here are a few comparisons between me as a basic nursing student and me as an advance practice nursing student:

1. If you don’t know it, know where and how to look it up!

When I was in nursing school, I carried around an average of four textbooks that totaled more than 75 lbs. I lugged my bookbag full of textbooks, notes, and drug reference guides everywhere I went. I can remember trying to figure out how I was going to stash my book bag while on clinicals, because students didn’t get lockers.

As an NP student, I’m still utilizing all the above, but now we have these things called smartphones–all 75 lbs worth of reference material in the palm of my hand. You gotta love technology.

2. The 7 P’s

Prior Proper Planning Prevents Piss-Poor Performance. (I think there are different versions, some more colorful than others. You can blame my time in the armed services for that one.)

I still remember the sleepless nights prior to a day of clinical. I would be up all hours of the night researching my meds, checking and rechecking contraindications, checking and rechecking the whys and why nots of a patient’s care. Oh, and care plans. Gooooood grief. I remember having to write them out. Objectives, interventions, outcomes…they still haunt me to this day.

Now as an NP student, I’m verifying evidence-based nursing and medical research management of care, risk reduction, test sensitivity, outcomes, and physiological response techniques. The game hasn’t changed, but the level of play is elevated beyond my imagination.

3. Stranger in a strange land

I remember the first time I set foot onto the clinical floor as a new student nurse. I was terrified. People were speaking a different language than me; they had a level of familiarity I could only dream of; and ultimately, they didn’t look scared and nothing shook them. I was in awe.

Boy, I can’t wait to feel that way again, let me tell you. (I hope you caught the sarcasm!)

In the end, I’m equal parts nervous, scared, anxious, excited, eager and motivated. Only time will tell how this first round of clinical rotations will go. Wish me luck.

Comstock | Thinkstock

Being on the opposite side of the bedside can be challenging.

When you go from being the caregiver to the one being cared for, how do you want to be treated? Better yet, how do you want to be spoken to?

It’s a real hot topic for many healthcare professionals, not just nurses. I’ve discovered over the course of my education that physicians have many of the same concerns.

When your physician needs to discuss your care, how do you want him or her to speak with you? Do you want him or her to spell everything out? Or can he or she talk to you as if you are colleagues? We all know that physicians speak to us very differently when in “work mode.”

When the physician assumes the wrong approach, it’s amazing the reactions you can get.

Those who are spoken to in “work mode” get offended that the physician might not be telling them everything. Those who choose to have everything spelled out for them get offended that the physician may be misjudging their education and knowledge level. Either way, we get offended!

If you were one of the offended, would you stop the physician and ask him or her to approach you differently? Or would you ride it out?

I think I’m a middle-of-the-road kind of nurse. I want things spelled out for me, but as they are being spelled out I think subconsciously I’d be offended (it makes no sense, but that’s how my mind works).

I think we as healthcare professionals over-analyze the playing field when it comes to wearing the “patient” shoes. Going from being in control to being controlled makes us a tad uncomfortable.

I’m willing to admit to the control theory. I hate not being in control–especially when it comes to my health!!

What about you–would you prefer to be spoken to as a layman or a colleague?

Robert Kneschke | Veer

I’m not a big fan of New Year’s resolutions, but this is the time of the year I wish we could openly call out our coworkers for their habits and idiosyncrasies that tend to drive us all up the proverbial wall.

I thought I might send an open letter to all “those” coworkers out there and address just a few of these occurrences that can get under our skin.

Dear fellow coworker,

It’s about time you started carrying your weight. Innocence and forgetfulness are one thing, but blatant disregard for your fellow nurse is starting to wear on us. Here are just a few things we’d like you to think about in 2012:

1. Be on time. No, that does not reflect the time you swipe your badge. If you’re going to spend 15 minutes gossiping and another 15 getting your gear and preparing your coffee, be sure to arrive ahead of time so that when you DO clock in, you’re ready to roll.
2. Lay off the cologne/perfume. We’re not out clubbin’. If I’m gagging in your presence, how do you think the patients who require oxygen are going to feel?
3. Look in the mirror before you leave for work. Wrinkled, mismatched and faded scrubs do not scream professionalism. Nor do white pants with colored undergarments. I’m jus’ sayin’.
4. If you must smoke, figure out a way not to take 30 minute smoke breaks four times per shift. You disappearing for who knows how long gets quite taxing. I may take up the darn habit just so I can take those long breaks.
5. Answer the damn phone when it rings. Really? You’re telling me you don’t hear it ringing right next to you?
6. While we’re on the subject of your hearing, maybe you could find some time to answer a couple of call bells while you’re at it. Yes, I see you over there making every attempt to look busy when the call bell goes off. Sorry, it’s not working.
7. Leave the darn magazines at home. Please. How do you find the time to read a magazine during your shift? What am I missing?
8. Figure out a way not to yawn in my ear when giving report. Please.
9. Oh, and while we’re talking about report, could you PLEASE be more concise and on target. While I can appreciate attention to detail, does it really take you that long to convey your findings?
10. By the way, thank you oh-so-much for repeatedly leaving me dry and empty IV bags!

And a bonus one!

If you have a patient who has a suppository order at the beginning of your shift–could you find way to give it so that I’m not ALWAYS cleaning up the mess (literally!). Once or twice maybe, but every time? C’mon?!

In my book, this list is actually short. I could go on and on about the “little” things that always become big in our nursing world. I think the golden rule applies here, gang.

Anyone care to add to the list?

P.S. These suggestions were compiled from more than one source.

iStockphoto | Thinkstock

Resolutioners are running amuck!

It’s the time of the year when you are reflecting on those promises you made last month. You know – what you vowed, promised and declared you were going to improve.

These proclamations ranged from the smallest to the largest feats.

We all know the most common resolutions have to do with your health in some way.

Why do we poke fun at this habit of yearly resolutions? Mostly because the yearly resolution has become somewhat of a bad omen (sort of like saying the Q-word on a nursing unit). Your resolution is almost never completed in its entirety.

Here’s what I think about making resolutions as a nurse and (ahem) keeping them!

Nurse-y resolutions!

For nurses looking to improve their overall well-being in 2012, here’s a list of resolutions that can very easily apply to most nurses:

1. Bring my lunch to work (more often or a certain number of times per week)
2. Stop snacking on goodies at work
3. Stop bringing money to buy vending machine food
4. Stop feeling guilty about not picking up extra shifts (or calling off for being sick)
5. Be more of a team player (help one person each shift )
6. Stop feeling guilty about leaving tasks for the next shift
7. Cut back on coffee and/or fast food
8. Quit smoking

Here are some tips to help you stay on track:

Timing

Since when do you need a date on a calendar to start a goal? Pick an arbitrary day and commit. Just because you chose a goal at the start of the new year does not guarantee its success. That said, what better time to start than the new year?

Too much

For some reason, people “go big or don’t go at all.” The best goals are made in small increments. Baby steps forward are much more effective than backpedaling.

Too little

Your yearly resolution doesn’t need to be accomplished in a set time frame. There is nothing wrong with completing your goal later in the year. Just be sure to set a due date! It’s there to motivate you and serve as an evaluation tool along the course of the year.

Peer pressure

Nothing brings out the best in you like some friendly competition. The competitive spirit is inside all of us–sometimes we just need a good push. Just be sure to remind yourself that your goals are unique, and so are your accomplishments. So quit drawing expectations from others.

Torture

A resolution is about improving your life, not making it worse. Try your best to keep a positive attitude. We all know that making changes to accommodate a new workout regimen or wean off of stimulants like coffee or cigarettes can feel like hell. Be sure to keep going. Imagine the reward for all your hard work and sacrifice. That thing you call torture will eventually become a habit and then a part of your new, healthier lifestyle. YOU DESERVE IT!

One last tip! Resolutions are all about making YOU and your new goal a priority. Don’t go in circles by starting-failing-stopping-starting-failing-stopping. Keep your goals out of the wash cycle!