“Up Out My Face” features Carey and collaborator Nicki Manaj in skimpy, skin-tight white nursing uniforms. Click on the video below to see what the fuss is all about.

Click here to view the embedded video.

The video, which was released in January 2010, is an affront to nurses, says Sandy Summers, executive director of The Truth About Nursing, a Baltimore-based advocacy group.  “These images associate nursing with female sexuality, undermining our claims to adequate resources,” Summers says.  The Truth About Nursing has mounted a letter writing campaign, asking Ms. Carey to withdraw the video and to refrain from using the “naughty nurse” image in future videos and shows.

But the general public — including some nurses — doesn’t understand what the fuss is all about.  Internet reactions to the protest so far have been strongly against The Truth About Nursing, with many commenters suggesting that the video is simply a harmless piece of fantasy.

Deep breathing might seem like a waste of time when you have a post-op wheeling down the hall, one patient waiting for discharge and an ER nurse on hold, ready to give you report on your new admission—not to mention your other patients who, hopefully, are holding their own. (Please let them be holding their own!)

But unless you get control of your thoughts, you’re going to spin your way through your shift without ever really knowing what to do next. You’ll lurch from one crisis to another, and then go home with your head still spinning, wondering if you truly did everything that needed to be done.

So find a quiet place and begin prioritizing. Make a list, if you’re a list person. What things absolutely, positively must be done? What has to be done now and what can wait until later?

Then think about available resources. Who can help you? Do you have a CNA assigned to you? Delegate, delegate, delegate! Is there another nurse you can ask for help? Ask! In fact, even if you think the answer is “There’s no one who can help me,” ask anyway. You may be surprised to find a colleague who is more than willing, for instance, to do some post-op vitals for you while you take report from the ER.

If you still feel overwhelmed, tell your charge nurse. Staying quiet helps no one—not you, not your patients and not the healthcare team. Express your concerns in a constructive manner, though. Flying off the handle and loudly complaining, “This is ridiculous! What do I look like, an octopus?” is probably not going to net you any additional help. (Laughter, by the way, can also help you cope with an impossible assignment.) You’d have better luck asking for help with specific tasks.

One final point: If you truly believe that your assignment is excessive and potentially endangering, it’s your responsibility to let someone know. Start with your immediate supervisor and work your way up the chain of command until someone listens.

[Image: Sam Edwards | OJO Images Collection | Getty Images]

There will come a time, at least once, in your career where you will hit a wall when you are trying to deal with your manager.  They don’t listen to what you have to say, they don’t want to work with you or they are just completely unreasonable.  When that happens, what do you do?

Here are my suggestions, these would work with me.

First, before you go talk to them make sure you have all your ducks-in-a-row.  What I mean is, be ready to present you case.  If your attendance has been perfect, show them.  If you have been a team player by picking up extra shifts when there are holes, or you have joined committees, be ready to talk about that.  On the flip side, if you call off a lot or are not engaged in the unit, be ready to explain.

Second, be honest and straight forward.  If you need time off to go somewhere silly like a Star Trek convention, don’t lie and say you are going to your grandma’s funeral, because when she really dies or already has, you will have to explain that.

Third, be prepared for questions or even an answer of NO!  Don’t get tongue tied and start stuttering, and don’t start crying.  Nothing is worse in my office than when somebody cries.

Don’t be afraid to ask questions.  Ask why.  Maybe there is something you don’t know about that the manager does know.  Maybe a couple other nurses are on FMLA, maybe there is a new process implementation that week and they really need your leadership.  Found out what you can do to help them out as well.

If you do get a NO, where do you go from there?  Well, you have a couple of options, try talking to them again, and make an even better case.  Or, take your argument to the next level.  But, be extra prepared for this course of action.  The Director or CNO will probably back up the manager’s decision, just like your manager should back you up on a conflict.  So, you need to have a better presentation to give the next level of management if you want to get what you want.

Be prepared and be honest.  When it comes to my staff I will listen to everyone’s case, and if that nurse is willing to help me out when needed, I will work with them…..I am awesome (that’s not arrogant, is it?).

I consider myself healthy – and I by no means torture myself, or punish myself.

I confessed last week to not being perfect and succumbing to cravings, and to also being just like you. I believe there is a ‘healthy’ balance between being healthy, being happy, being successful with your goals and maintaining your sanity. It’s all about control and it’s all about the ‘big picture’. Nothing more. Nothing less.

It’s learning to know when enough is enough. Learning to recognize your bad habits – and being able to stop them. Case in point: this past week at work a former patient brought in a box of chocolate to show their appreciation for the care they received during their stay. A whole box of chocolates.

My confession is I have a horrible sweet tooth. Horrible! We do not keep any sweets in the house because of this. If they are not accessible, I do not eat them. Well they were accessible. So I ate them.  I had one. Then I had another. Then another. Then another. By the end of the shift I was guilty of eating half the box!

I went home that night feeling all kinds of ‘guilty’. Oh, and I was feeling all kinds of sick – sick to my stomach. I wanted to go work out, I spent time bashing myself, punishing myself for what I had done. I was calculating the amount of empty/bad calories I consumed versus how many pounds of fat I was adding to my body… it was horrible.

Then I had an epiphany. I realized that I could not remember the last time I had done that. I couldn’t recall the last time I even had a piece of chocolate! I  happily remembered that I had taken control of this bad habit. I purposely don’t buy that stuff so that I don’t have the opportunity to gorge on the sweets.

I had taken control.

Yes, of course I lost control that day at work – but I knew what I did wrong. I knew what the solution was to the problem. And, I also knew this was temporary! The next day I went back to work. There was the other half of the box of chocolates and another newly unopened box! I promised myself and repeated throughout the day that I was in control, not the box. It was my choice to eat or not eat those delicious treats. I was not a victim, and it was nobody’s fault but my own if I repeated my actions from the day before.

I am proud to say I never even touched the box. And I never felt guilty that whole day for my previous day’s actions. In fact I felt good knowing that it happened. I had learned from the experience. I learned more about myself and my healthy lifestyle. I felt good.

Remember, we are human! We will and are going to make mistakes, we are going to ’slip up’. There is no road to weight loss that is not filled with bumps, hills and valleys, and frequent rest stops! Weight loss is a journey not a destination. Give yourself credit when credit is due and be sure to accept your mistakes.

The difference between success and failure in the journey to weight loss is making sure the good severely outweighs the bad. Have more good days than bad, and be sure to learn from each mistake and ’slip up’ you make.

Before you plug the machine, you’ll want to scan this “best foods to choose” checklist. We reveal that surprise! Some “healthy” foods are packed with sugar!

And guess what? Some potato chips are okay to eat…

Meals/Meal Substitutes

• Wrap made with deli meat, low-fat cheese and whole-wheat tortilla
• Turkey sandwich on whole-wheat bread
• Low-sodium soup
• High-protein nutrition bar
• Instant oatmeal (ideally the lower-sugar varieties)
• Chicken or tuna salad with whole-wheat crackers (look for low-fat mayo)

Snacks

• Edamame
• Baby carrots
• Almonds or peanuts
• Nonfat yogurt
• Apple, orange or banana
• Pretzels
• Dried fruit (check the sugar content, though…you’d be surprised how much is in a small bag of cranberries!)
• Baked chips (especially sweet potato or veggie crisp ones)
• Part-skim string cheese
• Laughing Cow Mini Babybel Light Original (the red wax-encased rounds)

Drinks

• Bottled water
• Vitamin-enhanced water (but look at the calorie counts!)
• 100-percent fruit juice
• Skim milk
• Unsweetened tea

Notes to remember:

1. To hydrate yourself, water is always best. Start with a bottle of water before eating one item from the snack list, then wait 20 minutes. You’ll feel more satisfied than when you’re just eating.
2. Watch your portion control on chips and crackers; those small bags often claim to be two servings. Look for the 100-calorie packs or practice awe-inspiring self-control and eat just half a bag.
3. High-protein nutrition bars are a good option on days when you have no time to sit. The higher protein level and somewhat higher fat level will give you a feeling of satiety longer than a plain granola bar.
4. If you find yourself with a selection of different cheeses in your vending machine sandwich (a luxury, we know!), look for low-fat Swiss, feta or part-skim mozzarella.

Thanks to columnist Diane Porter, RN, for her input on this checklist.

The orientation and training of nurses is very expensive.  As a manager of an Acute Care unit, I know that most of the nurses that I hire want to move on to other areas, ICU, ED Labor and Delivery.  I know this and I am good with it.  It is the nature of Acute Care.  But I want to keep them as long as possible to not only keep my unit staffed accordingly, but also to help them become the best Med/Surg nurses they can be.

So how do I keep them?  I don’t know.  I have written many times about team building and development, which is something I work on a lot.  I feel that if they staff feels they are a part of a strong, cohesive team, they will want to continue to be a part of that for a while.  I also recognize the teams, and individual accomplishments regularly to build esteem and trust from within the team.

My wife was just a part of a group that was working on retention of nurses at a competing hospital here in town.  I reviewed what they suggested to the nursing staff and it is a lot what I have been doing, and should be doing.  I am probably going to steal a few of their ideas and use them as my own.

Prairie View currently has over 100 nurses enrolled in its Masters of Science Degree in Nursing program; approximately one-third of those students are likely to continue their studies to the PhD level.  Adding the PhD program will allow those students to stay at Prairie View, if they so choose, and will ultimately increase the number of nurse educators in the state of Texas.

Funds from the grant will also be used to establish the Research Center for Virtual Interface for Teaching and Learning, which will study the effects of virtual simulation technology on nursing education.  Prairie View’s College of Nursing has used simulation teaching methods to practice critical thinking skills essential to nurses since 2003.  Results of the Center’s research will be used to enhance the education of new nurses.

Seriously, what is WRONG with me?!? I have legitimate scholarly pursuits to embark upon. I have work that needs to be done! I am a better person! I shouldn’t be procrastinating. I really shouldn’t. And yet, I can’t turn away. Tonight is lost for any hopes of productivity. I guess I will just finish watching this and go to bed. Maybe tomorrow will work out better for me. Assuming there are no reality tv wedding specials on for distraction.

“So what if I slipped on the stairs, my bones are probably brittle because of Osteogenesis Imperfecta.”

“My ears have been ringing more than usual. I know it’s Ménière’s disease.”

“I know it was snowing, but my hands are still cold. Off to the doctor for me, I’ve got Raynaud’s Disease.

“I have a new productive cough, but it just started after I swam at the lake. Oh man, it has to be Legionnaire’s Disease.”

Do any of these self-diagnosing tendencies sound familiar to my fellow nurses? Although I highlighted some of these conditions in jest, the reality exists that throughout nursing school we are immersed in a learning environment filled with obscure to some very common diseases that affect mankind.

Unlike a business degree, where discussions focus on economic recessions and ebbs and flows of the stock market, a degree in nursing following a passing grade in Pathophysiology brings with it a new world of worry- a world of diseases, conditions, and infectious processes that the graduate is now expected to treat. Somewhere along this transition and transformation from nursing student to experienced nurse the poor unlucky soul contracts EVERY SINGLE disease that she learned about in her NCLEX review book. Do not fear, my friends, it happened to me too. Perhaps it’s a nursing rite of passage, along with the letters RN behind your name comes a brief stint of the added middle name: Nicole “hypochondriac” Lehr, RN.

We’ve all been there…

Shortly after our exam on rheumatology, my roommate in nursing school awoke one morning at 6 a.m. and trudged into my room with complaints of not feeling well. “I just feel off this morning. My mouth is dry, my heart is racing, my head is pounding, and my ankle is suspiciously swollen.”

My attempts at de-escalating her thought process were futile, and I merely acted as her sounding board for the self-assessment she was performing. “Tachycardia… dehydration… pitting edema… pain of unknown origin. Has to be that autoimmune disorder causing degeneration of my joints that I just read about. I probably only have a couple of weeks left. I better tell Jen that I ate some of her Girl Scout cookies without asking, and I need to make arrangements to head back to Florida- Mom will want to see me…”

At that point I calmly reminded her that last night she attended our friend’s bachelorette party. Some Advil, a bottle of water, and her pillow started looking better than ever.

Q: Dear Nurse Pagana, As a new graduate, one of my biggest challenges has been calling a physician on the phone. I often feel flustered and unsure of myself. Then they get frustrated. Can you help? Does this get easier with experience? —Flustered on the Phone

A: Dear Flustered,
You’ve hit on a challenge for new as well as seasoned nurses. We all want to sound confident and act professionally. Try these tips:

• Remind yourself that the purpose of your call is to advocate for your patient. The call isn’t about you—it’s about helping someone else, and you’re the person to do it.
• Collect and have pertinent information at your fingertips—for example, the latest set of vital signs, intake and output, assessment data, current intravenous solutions, recent lab reports, list of medications, allergy information and the patient chart.
• Be sure you’re contacting the right physician. The orthopedic surgeon won’t want to be called about an abnormal heart rate. That call should be directed to the hospitalist or family doctor.
• Contact the doctor by his or her preferred method of contact. Many doctors are using cell phones and don’t want to be contacted on their home phone.
• If you’re asking a unit clerk to initiate the call, be specific with your instructions — for example, “Please call Dr. Colony at his office and say that I would like to speak to him about the blood pressure on Sarah Parrish.”
• Be available for quick access when the call is returned. Make sure the unit clerk can quickly locate you.
• Have an order form available and ready to use for phone orders.

Following these tips will help you handle this challenge in a professional and confident manner.

[main image: Jack Hollingsworth | Blend Images | Getty Images]